Efficacy of Clinical Evaluation of Lower Lateral Cartilage Malpositioning Diagnosis

Introduction: The external nasal valve insufficiency is related to factors that may incur in lack of nose side wall support. Resistance to collapse is determined by the strength and shape of the lower lateral cartilage (LLC) and also by its position. The LLC malposition was clinically described by Sheen, but Daniel later proposes that the evaluation should be performed during surgery, measuring the distance from the caudal edge of the lateral crus to the nostril’s midpoint.

Objective: To compare the preoperative clinical evaluation of the LLC's position with its corresponding intraoperative measurement.

Methods: Cross-sectional exploratory study of functional or aesthetic rhinoplasty patients. Clinical evaluation of the LLC’s position through ectoscopy and palpation. Intraoperative measurement of the distance in millimeters from the LLC’s edge to the nostril's midpoint.

Results: Twenty-seven patients were included. The surgical average measurement found was 6.52 mm. The malposition was clinically identified in seven and surgically in eight patients. Eighteen patients had well-positioned cartilage and six were diagnosed with malposition in both clinical and surgical evaluations. Two patients had a diagnosis of clinically well-positioned LLC, but with surgical findings of malposition, and one patient supposedly had a malposition in clinical evaluation with intraoperative findings of well-positioned cartilage.

Conclusion: The paper shows that LLC malposition is easily diagnosed by clinical inspection and palpation with statistically significant correspondence to surgical findings.