Burun estetiğinde burun ucu desteği değişikliklerinin değerlendirilmesi

EVALUATION OF NASAL TIP SUPPORT IN SEPTORHINOPLASTY Erol O, Evaluation of nasal tip support in septorhinoplasty, Baskent University School of Medicine, Otorhinolaryngology Department, M.D. Thesis, Ankara 2018. Study Design: Prospective, blind Materials and Method: This study is conducted at, Baskent University School of Medicine, Otorhinolaryngology Department between February 2018- March 2018. 15 patients undergoing open technique aesthetic rhinoplasty are included. Informed consent is obtained from all patients. Patients having history of previous nose surgery and patients with caudal septum deviation are excluded. All procedures are performed by a single surgeon. Patients operated using following techniques are included in this study: midcolumellar incision, flap elevation, caudal septum resection, tongue-in-groove technique, columellar strut grafting and tip intervention. These techniques previously cited are carried out in exact same order for all the patients during surgery. Caudal strut and tongue-in-groove techniques are optionally performed for suitable patients as seen necessary by the surgeon. Measurements are taken in between all the stages, preoperatively; following caudal septum resection; columellar strut grafting; tongue-in-groove (chosen patients only); tip interventions (saturation and grafting) and early postoperative period immediately after closing columellar incision, while applying 1mm, 2mm and 3mm compression forces to tip area. Newtonmeter is used for resistance measurements (SF-50Newton Dijital Dinamometre, EgeRate). Serial photos are taken and video recordings are obtained with a scale placed adjacent to columella during application of compressive forces. Subsequently these recordings are analyzed and data are documented. Results: Mean age for the study group was 24,8±4,9 ranging between 19and 35. %66.6 (n=10) of the patients were female, %33,4 (n=5) were male. Significant reduction in tip support following caudal septum resection is detected. Significant increase in tip support is observed following tongue-in-groove technique compared to all other maneuvers (p<0.05). There was no significant difference between preoperative and postoperative tip support for columellar strut grafting. Additionally tip support is found to be significantly reduced after dissection of intradomal ligaments which showed improvement with repair (p<0,05). Conclusion: This study shows application of testing equipment for evaluating and measuring nasal tip support following various rhinoplasty maneuvers. Caudal strut grafting revealed no increase in tip support. Tongue-in-groove technique has shown to improve nasal tip support at the utmost compared to other techniques employed. Keywords: rhinoplasty, tip support, tip surgery newtonmeter