Scroll Ligament Preservation and Improvement in Nasal Tip with the Room Concept.

[INTRODUCTION] In rhinoplasty operations, concavity and convexity have a particular place in terms of aesthetic and functional problems. To fix the problems associated with concavity and convexity, several techniques were reported for straightening of the lower lateral cartilage (LLC). The scroll ligament and its associated tissues can be preserved, and a better nasal tip can be obtained after the surgery. The purpose of this research is to present a new, more comfortable and more practical technique to overcome the problems associated with LLC.

[METHODS] The records of 190 patients who were operated on with this novel technique were assessed retrospectively. In the present "superior-based sliding flap" technique, the LLC remained thick and stable; therefore, a particular functional improvement was achieved. Additionally, the scroll ligament was preserved, so this technique prevented the accumulation of skin at the nose tip. Patients were evaluated using the "Rhinoplasty Outcome Evaluation" (ROE) 12 months after the surgery.

[RESULTS] The median patient age was 24.3 years. Among 190 patients, 23 were male (12.1%) and 167 were female (87.9%). All patients included in the study completed the ROE questionnaire. Patient satisfaction was excellent, registering at 95% of the included cases. In the assessment of nasal obstruction, it was found that the patients' patency score increased to 8.8 from 6.2 (out of 10) after the 12-month follow-up (p < 0.001). Revision surgery was not needed in any patient.

[CONCLUSION] The ability to have control over the LLC for all shapes via suturing two different points together is a noteworthy benefit of this technique. This is a safe, controlled and easily applicable technique that can be applied to generally every patient without the need for additional grafts.

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