Evaluation of the effects of tip-binding sutures and cartilaginous grafts on tip projection and rotation.

BACKGROUND: Numerous approaches and techniques have been described to achieve a desired result in tip surgery, but there are few studies that define or analyze the changes that occur after surgery. Therefore, the authors planned a study to document changes in nasal tip projection, crural and lobular lengths of the columella, columellar length, and proportional relationships of tip projection and columella with dorsal length.

METHODS: Analysis was based on data collected from preoperative and 1-year postoperative lateral views of 18 patients who were randomly chosen. The tip-binding suture group included nine patients and the cartilaginous graft group included nine patients. The measurements were obtained using the parameters regarding tip projection and rotation on standardized photographs. The values were statistically analyzed with paired and unpaired t tests.

RESULTS: The changes in all parameters except crural length were statistically significant in the tip-binding suture group. In contrast, the statistical analysis of the cartilaginous graft group revealed prominent dimensional changes in tip projection and especially in crural and lobular segments.

CONCLUSIONS: The authors believe that cartilaginous grafts should be considered if the dimensional changes have priority in the preoperative plan. The columellar strut graft provides satisfactory structural tip support and dimensional changes in crural length. Shield grafting causes augmentation in the lobular segment. If minor dimensional changes with more rotational alterations are planned, tip suture techniques should be preferred.