A Comparison of the Lateral Crural Suspension Flap and Tongue in Groove Techniques in Rhinoplasty Patients with Hanging Columella

Background: Many methods have been proposed to improve the rotation and projection of the nasal tip and thus achieve the desired appearance. TIG is one of the most successful and minimally invasive surgical procedures, which is conservative to control projection and rotation of the tip and to correct the deviation of the caudal septum and stabilize the base of the nose.The lateral crura suspension method is a simple and stable method that uses the cephalic parts of the lower lateral crura cartilages in the form of two flaps to suspend the tip of the nose to the septum to correct and stabilize the nasolabial angle. This technique is also easily repeatable. According to the mentioned materials, we decided to investigate the results of lateral crural suspension flap and TIG in patients with hanging columella at Imam Khomeini Hospital in Ahvaz. Materials and Methods: In this retrospective comparative study, documents of patients who referred to Imam Khomeini Hospital in Ahvaz for rhinoplasty were examined. Digital photographic images were prepared according to clinical standards before and six months after the operation, in the left and right lateral, anterior and basal views. In lateral images, Goods ratio, nasolabial angle, ala-columella ratio were examined. After general anesthesia, with open rhinoplasty technique and transcolumellar incision, all incisions were made in perichondrial and subperiosteal planes. After incision and skin flap, one of the two techniques of lateral crural suspension or TIG was applied to create the desired position of the nasal tip for the patient. All patients were followed up for 6 months and changes in nasolabial angle and nasal tip projection were evaluated by statistical tests. Results: In this research, 50 people with an average age of 26.5±4.23 years were examined. Half of the investigated people, 25 people, were in the lateral crural suspension group and the other half were in the TIG group. According to the Mann-Whitney test, the nasolabial angle of patients after rhinoplasty was compared, in both groups the angle was increased after the operation and this average difference between the two groups was not statistically significant (p>0.05). The Goode ratio of patients in both groups was increased after surgery and this average difference between the two groups was not statistically significant (p>0.05). The alar-columella ratio of patients after rhinoplasty decreased in both groups and this difference in the average of the two groups was not statistically significant (p>0.05). Conclusion: Either TIG and lateral crural suspension flap significantly improve postoperative aesthetic results and there was no statistically significant difference between them.