Nocini Riccardo, Magagnotto Nicola, Chirumbolo Salvatore, Albanese Massimo, Bertossi Dario
Unit of Otolaryngology, Head and Neck Department, School of Medicine, University of Verona, 37134 Verona, Italy.
Unit of Dental and Maxillofacial Surgery, Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37134 Verona, Italy.
Diagnostics (Basel). 2025 Aug 15;15(16):2051. doi: 10.3390/diagnostics15162051.
: The columellar strut and septal extension graft are two common techniques in modern rhinoplasty to enhance nasal tip projection and rotation, though their effectiveness varies. While numerous studies examine each technique individually, there is limited research directly comparing the two methods, especially regarding long-term outcomes. This study aims to clarify the roles of these grafting techniques and possibly compare their long-term effectiveness in reconstructing caudal nasal support structures with available evidence in the literature. : A comparative study was conducted on 87 patients with structural and anatomical nasal defects who underwent rhinoplasty using either a columellar strut or a septal extension graft. Outcome variables included tip projection, tip rotation, and nasal length. Patients were evaluated pre-operatively and at intervals of 1 month, 6 months, 1 year, and 4 years post-operatively. A critical discussion was also conducted to define the roles of the two nasal grafts and assess their long-term effectiveness. : Although over 4000 publications address the use of grafts in rhinoplasty, only a few compare the two grafting techniques directly. Our analysis revealed mixed perspectives on the columellar strut: some argue it is unnecessary, while others suggest it is not superior to septo-columellar suturing techniques. Conversely, several studies highlight the septal extension graft's importance in reconstructing nasal support, with some evidence indicating it outperforms the columellar strut in maintaining long-term structure. : Both grafts contribute to increased nasal projection; however, the septal extension graft provides more stable, long-term tip position support. The columellar strut appears non-essential for enhancing tip projection and should be used selectively, as it increases projection only when specifically designed for that purpose by the surgeon.
鼻小柱支撑移植物和鼻中隔延伸移植物是现代鼻整形术中用于增强鼻尖突出度和旋转度的两种常见技术，但其效果各不相同。虽然有大量研究分别考察了每种技术，但直接比较这两种方法的研究有限，尤其是关于长期效果的研究。本研究旨在阐明这些移植技术的作用，并可能根据文献中的现有证据比较它们在重建鼻尾端支撑结构方面的长期效果。
对87例有鼻结构和解剖缺陷并接受了使用鼻小柱支撑移植物或鼻中隔延伸移植物进行鼻整形术的患者进行了一项对比研究。结果变量包括鼻尖突出度、鼻尖旋转度和鼻长度。在术前以及术后1个月、6个月、1年和4年对患者进行评估。还进行了深入讨论以明确两种鼻移植物的作用并评估其长期效果。
虽然有4000多篇出版物涉及鼻整形术中移植物的使用，但只有少数直接比较了这两种移植技术。我们的分析揭示了对鼻小柱支撑移植物的不同观点：一些人认为它没有必要，而另一些人则认为它并不优于鼻中隔-鼻小柱缝合技术。相反，一些研究强调了鼻中隔延伸移植物在重建鼻支撑方面的重要性，一些证据表明它在维持长期结构方面优于鼻小柱支撑移植物。
两种移植物都有助于增加鼻突出度；然而，鼻中隔延伸移植物能提供更稳定、长期的鼻尖位置支撑。鼻小柱支撑移植物对于增强鼻尖突出度似乎并非必不可少，应选择性使用，因为只有当外科医生专门为此目的设计时它才会增加突出度。
