title: Effects of various submucous resection techniques of septal cartilage on nasal tip projection.
abstract: BACKGROUND
  There is little research which determines whether septoplasty affects nasal projection.
  
  
  OBJECTIVE
  To assess the effect of various septoplasty (submucous resection, SMR) techniques on nasal tip projection in a fresh cadaver model.
  
  
  METHODS
  The nasal tip projection was measured on 6 fresh cadaver heads and compared postoperatively after a sequence of submucous septoplasty maneuvers. Five different septoplasty techniques were performed in the same sequence on each cadaver. After each technique, measurements were performed.
  
  
  RESULTS
  Removal of a central square piece of quadrangular cartilage resulted in a loss of projection in 3 in 6 (50%) heads, with average loss of 7.76%. Removal of additional cartilage along the bony cartilaginous junction resulted in no loss of projection. Removing more septum along the floor resulted caused a change loss in nasal projection in 1 in 6 (17%) cadavers. Removing the remaining septum, except for the L-strut resulted in a loss of projection in 2 in 6 (33%) heads with an average percent change in tip projection of 9.08%. Swinging door technique resulted in a loss of projection in 1 cadaver (17%), with loss of 6.25%. All 6 cadavers experienced loss of nasal projection. When all maneuvers were taken in total, there was a statically significant average decrease in projection of 8.93% (range, 5.00-13.04%, p = 0.008).
  
  
  CONCLUSIONS
  Primary septoplasty carries a risk of nasal tip projection, with certain maneuvers carrying higher risk.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery. University of Washington, Seattle, WA, USA. rzoumalan@gmail.com
authors.forename: Richard A
authors.initials: RA
authors.lastname: Zoumalan
authors.forename: Luc G T
authors.initials: LG
authors.lastname: Morris
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Zeitler
authors.forename: Anil R
authors.initials: AR
authors.lastname: Shah
mesh_terms: D002102:Cadaver; D006801:Humans; D055171:Nasal Cartilages / Q000601:surgery*; D009300:Nasal Septum / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology; D012225:Rhinoplasty / Q000379:methods*; D012307:Risk Factors