Ar et Ç er çi Ö zk an, E rol K o z anoğlu
The Turkish Journal of Ear Nose and Throat - 2025;35(3):129-133
Objectiv e: Na s a l tip st abilis ation is one of the k e y c omponents of a suc c es sful rhinopl a st y . Ext ension gr afting is one of the most r eliabl e t echniques f or tip st abilis ation. If the c auda l septum r et ains a slight tilt aft er sept o2 pl a st y , the e xt ension gr aft c an be fix at ed on the opposit e side of the sept a l tilt t o achie v e midline a lignment . Despit e these me a sur es, the side2 t o2side fix ation of an e xt ension gr aft ma y still nec es sit at e c ount erb a l ancing. In this study , a no v el c ount erb a l ancing manoeuvr e is described with its pr eliminary r esults. Mat eria ls and Methods: P rimary rhinopl a st y p atients who had a slight tilt aft er sept opl a st y between Mar ch 20 22 and April 20 2 4 wer e included in this study . The p atients wer e c andidat es f or side2 t o2side fix ation of a c ount erb a l ancing gr aft that w a s harv est ed fr om the b a s a l p art of the na s a l septum in a ll p atients. This specific portion of the sept a l c artil a g e thick ens and widens a s it ne ar s its att achment t o the v omerine bone , giving it a unique in v ert ed drumstick appe ar anc e in the tr ans v er se pl ane . An L 2shaped or g olf stick 2shaped gr aft f orm w a s cr e at ed b y sc ulpting the harv est ed c artil a g e; thus, c ount erb a l ancing w a s maint ained with the help of this structur ed gr aft . If the tilt w a s t ow ar ds the l eft , the e xt ension gr aft w a s fix at ed on the right side of the septum, and the thick ened b a se of the gr aft w a s disc ar ded fr om the right side . If the tilt w a s t ow ar ds the right , the e xt ension gr aft w a s fix at ed on the l eft side of the septum, and the thick ened b a se w a s r emo v ed fr om the l eft side . The demogr aphic det ails of the p atients wer e r ec or ded, and the l at e oper ativ e out c omes of the p atients wer e e v a luat ed using st andar d phot ogr aphs. An y tilts of the tip wer e r ec or ded. R esults: A t ot a l of 13 4 primary rhinopl a st y oper ations wer e perf ormed using the pr oposed L 2shaped e xt ension gr aft with side2 t o2side fix ation. Se v ent y 2six p atients wer e f ema l e , wher e a s 58 wer e ma l e . In 9 3 c a ses, the e xt ension gr aft w a s fix at ed on the right side of the na s a l septum, wher e a s in 4 1 c a ses, fix ation oc c urr ed on the l eft side . The me an f oll ow2up w a s 2 1 months (9- 3 4 months). C onclusion: By using the unique anat om y of the sept a l b a se , the pr oposed manoeuvr e enabl es pr ecise c ount erb a l ancing of the gr aft , ensuring st abl e na s a l tip a lignment and s ymmetry .
