Lateral Crural Steal With Columellar Strut Graft in Primary Open Rhinoplasty
The Effect of Lateral Crural Steal With Columellar Strut Graft on Nasal Tip Projection and Rotation in Primary Open Rhinoplasty
Kafrelsheikh University
22 participants
Jan 5, 2026
INTERVENTIONAL
Conditions
Summary
The goal of this clinical trial is to assess the effect of Lateral crural steal with Columellar strut graft done in Primary Open Rhinoplasty and its long-term sustainability on nasal tip projection and nasal tip rotation.
Eligibility
Inclusion Criteria3
- Patients seeking primary rhinoplasty for aesthetic and/or functional indications.
- Presence of inadequate nasal tip projection and/or rotation suitable for correction using lateral crural steal with columellar strut graft.
- Ability to provide written informed consent and comply with follow-up visits.
Exclusion Criteria8
- History of prior nasal surgery.
- History of severe nasal trauma, altering cartilage architecture.
- Significant functional nasal obstruction requiring complex external nasal valve reconstruction.
- Patients with excessively wide alar base requiring alar base reduction involving vestibular sill excision (to prevent confounding on projection/rotation).
- Patients with facial skeletal or developmental abnormalities e.g. maxillary hypoplasia, maxillary prognathism, dentofacial deformities.
- Patients with psychiatric illness or Body Dysmorphic Disorder.
- Significant medical comorbidities contraindicating elective surgery or general anesthesia.
- Inability to provide informed consent or comply with follow-up.
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Interventions
Patients undergo primary open rhinoplasty under general anesthesia. After local infiltration, an open approach is performed using an inverted-V transcolumellar incision with bilateral marginal incisions. The skin-soft tissue envelope is elevated in the supra-perichondrial plane. Dorsal deformities are corrected and septoplasty is performed with cartilage harvest. Vestibular skin is undermined and cephalic trimming of the lateral crura is carried out. Lateral crural steal is performed by advancing the medial end of the lateral crus 3-5 mm medially using transdomal sutures after defining the new dome position. A fixed columellar strut graft is inserted between the medial crura and secured to provide central tip support. Interdomal sutures are placed. No additional projection-enhancing grafts are used. Incisions are closed and internal and external nasal splints are applied.
Locations(1)
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NCT07317947