Comparative Analysis of Nasal Tip Stability: Columellar Strut Graft Alone vs. Combination with Flexible Tongue-in-Groove.

[BACKGROUND] This study aimed to evaluate the effects of the flexible tongue-in-groove (TIG) technique on nasal tip stability in patients undergoing columellar strut graft (CSG) placement. Nasal tip rotation and projection changes were compared between patients who underwent CSG with the flexible TIG technique and those who received CSG alone.

[METHODS] A retrospective analysis was conducted on 88 patients who underwent primary open approach septorhinoplasty with CSG placement between January 2022 and June 2024. Patients were divided into two groups: CSG with flexible TIG (n = 44) and CSG alone (n = 44). Nasal tip rotation was assessed using the nasolabial angle (NLA), and nasal tip projection was evaluated using the Goode ratio. Measurements were obtained preoperatively, at 1 week postoperatively, and at 12 months postoperatively. Statistical analysis was performed.

[RESULTS] Patients who underwent CSG with flexible TIG had significantly less nasal tip rotation loss (5.18 ± 3.01) compared to those with CSG alone (11.95 ± 5.59, p <0.0001). Similarly, the flexible TIG group demonstrated significantly lower nasal tip projection loss over time (0.03 ± 0.018 vs. 0.04 ± 0.024, p =0.004). Pearson correlation analysis demonstrated a statistically significant positive association between the degree of intraoperative change in the NLA and the amount of NLA loss observed at long-term follow-up (r = 0.356, p = 0.001).

[CONCLUSION] CSG combined with the flexible TIG technique has been shown to provide better long-term nasal tip rotation and projection stability compared to the use of CSG alone. Our findings suggest that the flexible TIG technique overcomes some of the limitations associated with the use of CSG alone.

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