Comparative Outcomes of Septal Extension versus Columellar Strut Grafts for Nasal Tip Stabilization and Positioning in Rhinoplasty: A Systematic Review and Meta-analysis

a. Introduction Columellar strut graft (CSG) and septal extension graft (SEG) are commonly used in septorhinoplasty for nasal tip support. b. Objective & Hypotheses We aimed to systematically review and compared CSG and SEG in achieving a desired nasolabial angle (NLA) and Goode's ratio (GR). c. Study Design Several databases were systematically searched from inception to August 2024. Two-arm meta-analysis of the pooled means was conducted with a random-effects model. This review was registered in PROSPERO (CRD42024574909). d. Methods Eligible studies included primary septorhinoplasty patients (≥ 17 years) receiving CSG or SEG. e. Results Eight studies met eligibility criteria including 256 CSG and 371 SEG patients. Inter-group comparison of long-term post-operative NLA favored SEG (p < 0.05) while GR showed no differences. However, SEG patients had significant improvement in GR post-operatively (p < 0.05), unlike CSG patients. f. Conclusions SEG may provide superior long-term nasal tip rotation and projection stability.