A Technique for Treatment of Lateral Crus Malposition and Alar Rim Retraction Simultaneously in Rhinoplasty: Caudal Extended Lateral Crural Strut Graft

Abstract

Objective: Cephalic malposition and weakness of the lateral crus may result in a long alar line, boxy nasal tip, parenthesis-deformity of the alar rim and external nasal valve insufficiency in deep inspiration, in addition to alar retraction. There is no gold standard method for correcting alar retraction and lateral crus deformities in rhinoplasty operations. Caudal extended lateral crural strut (CELCS) graft is a technique used to correct malposition of the lateral crus, to strengthen a weak lateral crus and to correct the alar rim retraction. An autologous septal cartilage graft may be used during CELCS. Methods: CELCS graft was placed in 46 primary, open rhinoplasty procedures between 2014 and 2019. The graft was harvested from septal cartilage and placed on the lateral crus so that the cephalic areas overlapped while the caudal portion would extend into the pocket created in the caudal rim. Results: Of the 46 patients, 30 (65.2%) were female and 16 (34.8%) were male. Median (range) age was 32 (23 to 41) years. All patients underwent CELCS graft, placed to correction cephalic malposition and alar rim retraction simultaneously. The average follow-up period was 12 months (9-15 months). Satisfactory results were achieved in all patients. Conclusion: CELCS graft was a successful method to correct both lateral crus malposition and alar rim retraction simultaneously.

Keywords

• alar
• rim
• retraction
• malposition
• crus
• lateral

Rinoplasti Ameliyatında Lateral Krus Malpozisyonu ve Alar Rim Retraksiyonunun Simültane Düzeltilmesi: Kaudale Uzatılmış Lateral Krus Strut Grefti

Abstract

Amaç: Sefalik malpozisyon ve zayıf lateral kurus birlikteliği uzun alar çizgi, boxy burun ucu, parantez rim deformitesi ve eksternal nazal valv yetmezliği yanında alar rimde çekintiye neden olur. Lateral kurus deformitesi ve alar rim çekintisini eş zamanlı düzelten altın standart tedavi yöntemi yoktur. Hastanın septal kartilajından alınarak kaudal kenarı rime uzanacak şekilde lateral kurusun üzerine adapte edilen “kaudale uzatılmış lateral kurus strat grefti” kurusu güçlendirirken rimdeki çekintiyide düzeltir. Yöntem: Kaudale uzatılmış lateral kurus strat grefti, 2014-2019 yılları arasında primer açık rinoplasti uygulanan 46 hastada kullanıldı. Septal kartilajdan alınan greft sefalik tarafta lateral kurusla üst üste, kaudal tarafta rimde açılan poşa gelecek şekilde konuldu. Bulgular: Hastaların 30’u (%65,2) kadın, 16’sı (%34,8) erkekti. Hastaların ortalama yaşı 32’ydi (23-41). Kaudale uzatılmış lateral kurus strat grefti tüm hastalarda sefalik malpozisyon ve rim çekintisini eş zamanlı düzeltmek için kullanıldı. Ortalama takip süresi 12 aydı (9-15 ay). Tüm hastalarda başarılı sonuçlar elde edildi. Sonuç: Kaudale uzatışmış lateral kurus grefti lateral kurusun sefalik malpozisyonu ile alar rimdeki çekintiyi eş zamanlı düzeltebilen başarılı bir yöntemdir.

Keywords

• alar
• kurus
• lateral
• malpozisyon
• rim
• çekinti

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