Efficiency of Middle Vault Reconstruction with Dorsal Septal T Flap in Achieving Ideal Dorsal Aesthetic Lines and Regularity.

[BACKGROUND] Dorsal aesthetic lines and irregularities are the most critical points that can be manipulated in rhinoplasty operations. Although spreader grafts and flaps have been used for this purpose in the reconstruction of the keystone area for a long time, dorsal irregularity is often inevitable. This study aims to evaluate the effectiveness of dorsal septal T flap and nasal dorsum reconstruction in achieving ideal dorsal aesthetic lines and regularity.

[METHODS] Thirty-four patients (30 women, 4 men) who underwent closed technique rhinoplasty between 2019 and 2021 were included in the study. The mean age of the patients was 25.4 years. Patients with crooked nose, severe deviation, and severe dorsal hump were also excluded. All patients included in the study underwent Rhinoplasty Outcome Evaluation (ROE) questionnaires preoperative and postoperative 1st year.

[RESULTS] The mean age of the patients was 25.4 years (range 18-40 years). A total of 34 patients, including 30 women and four men, were operated. The mean follow-up period was 13.2 months, ranging from 12 to 14 months. In the physical examinations performed at the control visits, no functional problem was encountered in any patients. Preoperative and postoperative mean ROE scores were 60.9 and 92.7, respectively.

[CONCLUSIONS] With the technique described in the study, dorsal hump recurrence is minimized compared to other preservation techniques. Since the keystone area transition can be fine-tuned, continuity is ensured, and ideal dorsal aesthetic lines are created. The stability of the upper lateral cartilages is provided, thus eliminating the need for spreader grafts.

[LEVEL OF EVIDENCE V] This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .