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Background: Columellar strut grafts (CSG) are effective in providing the unity of the nasal tip with a weak,short, medial, or middle crura. However, its effect on tip stabilization is minimal. The CSG may be fixated to an autoextension at the caudal septum to augment the stabilization capacity of the strut. Septal auto-extension may not be applicable in cases with a short/shortened caudal septum, which can be solved by designing an extension in the middle of the CSG, which can be called an “inverted T-shaped CSG.”
Methods: Patients who underwent tip stabilization with an inverted T-shaped CSG between January 2019 and November 2021 were selected for this research. All patients underwent open structural rhinoplasty. The inverted T-shaped CSG was prepared similarly to the standard strut. However, spike-like extension was preserved in the middle of the strut, branching out at a right angle. The T-shaped CSG was settled between the medial crura. Then, the extension was fixated to the caudal septum. Medial crura were sutured over the inverted T-shaped CSG, and stability was established. Preoperative, peroperative, and postoperative images were analyzed.
Results: This technique was used in 64 patients. The average age was 37 years (26-48 years). Thirty-five patients were female, and 29 were male. Forty-one patients had undergone primary rhinoplasty, and 23 had undergone secondary rhinoplasty. The mean patient follow-up was 14 months (8-22 months). Statistical analysis was used to compare tip projection ratios and nasolabial angle calculations. A statistically meaningful difference was observed between preoperative, immediate postoperative, and 1-year postoperative measurements of the projection ratio and nasolabial angle increase in all cases, and this projection was observed to be maintained at 1 year. The inverted T-shaped CSG provided satisfactory tip stabilization in all patients.
Conclusion: The inverted T-shaped CSG is a good alternative for tip stabilization with graft economy, without columellar retraction, overortation, stiffness, in short/shortened septae.
Cite this article as: Özkan AC, Bilgili AM, Kozanoğlu E, Çiçek MM. The inverted T-shaped columellar strut graft: A new technique for tip stabilization in short or shortened caudal septum. B-ENT. 2024;20(2):85-93.