Application of perpendicular plate of ethmoid bone in short nose plasty in Chinese with insufficient septal cartilage

Abstract

Objective To evaluate the applied value of septal cartilage combined with perpendicular plate of ethmoid bone graft in short nose plasty in Chinese people with insufficient septal cartilage. Methods From February 2015 to March 2017, thirty-five women with short noses underwent septal extension grafting in our institute. We used perpendicular plate of ethmoid bone to enhance the L-strut structure. An L-strut, comprising 0.6 cm segments of the caudal and dorsal cartilaginous septum, was left altered to harvest more cartilages for septal extension. The harvested septal cartilage was grafted on one side of the caudal septum. Then the alar cartilage was fixed at the end of the septal cartilage graft. Nasal lengths and nasolabial angles were measured pre- and postoperatively. Results The average nasal lengthening was (3.37±1.87) mm (P<0.001). There was no infection, cerebral spinal fluid leakage, hemorrhage and other complications postoperatively. The average follow-up was 10 months (6 months to 2 years). After operation, 33 patients were satisfied with the nasal contour, 1 patient complained of high tip projection whereas one patient complained of low tip projection, and the dissatisfactions were corrected by revision surgeries. Conclusions Combining the septal cartilage with perpendicular plate of ethmoid bone graft presents an adequate nose lengthening and a decreased nostril show, even in patients with very little septal cartilage. With minimum complications, this novel technique provides promising clinical outcomes and high patient satisfaction. Key words: Short nose; Perpendicular plate of ethmoid bone; Septal reinforced implant; Rhinoplasty