Biomechanics of the deformity of septal L-Struts.

OBJECTIVES/HYPOTHESIS: A septal L-strut is often preserved or created during septoplasty. The main intention is to provide structural stability and to straighten the nasal septum. Deformity or excessive deformation of the L-strut might cause functional or aesthetic complications. The objectives were to examine the effects of material properties, the boundary conditions, the nasal tip support, and the geometry of the L-struts on the deformity of septal L-struts.

STUDY DESIGN

Computer-aided modeling was used to create a spring-supported nasal tip and free nasal tip L strut septal cartilage models upon which simulation was performed to analyse the deformation patterns.

METHODS

A five-sided septum model was first created from the computed tomography scan of a human subject. Several models with various combinations of wider or narrower dorsal struts as well as arc of cartilage were then constructed from this septum model. The edges connected to bony supports were assumed to be fixed, and the nasal tip was assumed to be spring supported. Finite element analyses were carried out to determine the deformation and stress distribution in the septal strut for different combinations of material properties and nasal tip spring support.

RESULTS

The spring-supported nasal tip model provides a more accurate representation of the boundary conditions in the nose. In both the free and spring-supported nasal tips-the BC junction and the nasal spine are found to be the consistent points of maximum stress regardless of material properties. The preservation of an arc of cartilage and a wider dorsal strut increase the stability of the structure.

CONCLUSIONS

The introduction of a spring-supported nasal tip model provided a more accurate representation of the boundary conditions in the nose. The bony-cartilaginous junction and the nasal spine were found to be the consistent points of maximum stress, regardless of material properties. The preservation of an arc of cartilage and a wider dorsal strut increased the stability of the structure.