Dorsal Preservation Rhinoplasty: Method and Outcomes of the Modified Subdorsal Strip Method

Overview

Dorsal preservation techniques have drawn attention because of claims that they produce better breathing and appearance than conventional hump reduction. The septum can be handled several ways in these operations, and the differences come mainly from where cartilage is removed from it. The article describes the technical considerations of one method that keeps supporting struts of cartilage in place.

Sections of note

• Review and technique article; the abstract reports no patient numbers, no complication rates and no follow up length.
• Three locations of septal excision are named: subdorsal resection, midseptal resection and inferior septal resection.
• The described technique is a modified subdorsal strip method using a structural preservation approach.
• The technique maintains both a subdorsal strut and a caudal strut of cartilage.
• The authors state patient reported measures demonstrate significantly improved functional and aesthetic outcomes after the procedure.

What it means for a patient

• Where the surgeon removes septal cartilage determines how the bridge settles down and how well it is supported afterward.
• Keeping two struts is intended to preserve support that other preservation methods give up.
• The claim of significantly improved outcomes carries no numbers, no sample size and no comparison group in the abstract.
• Nothing here compares this method with conventional hump reduction.

Why this paper matters

Septal management is the point at which preservation techniques differ from one another, and it determines both the amount of lowering achievable and the stability afterward. This article sets out one variant. Whether it outperforms other septal approaches has not been tested.

Terms

• Dorsal preservation: lowering the natural nasal bridge instead of cutting the hump off.
• Subdorsal strip: a strip of septal cartilage removed just beneath the bridge so the bridge can drop.
• Caudal strut: the front lower portion of the septum, which supports the nasal tip.
• Hump reduction: the conventional approach of cutting the bump away and rebuilding the roof.
• Patient reported measure: a questionnaire the patient completes rather than the surgeon.