title: The effect of polydioxanone absorbable plates in septorhinoplasty for stabilizing caudal septal extension grafts.
abstract: OBJECTIVE
  Caudal septal extension grafts (CSEGs) can be used to alter and secure nasal projection and length. Graft position and thickness play an important role in terms of both function and aesthetics. The limitations of harvesting cartilage from additional sites necessitate development of a more efficient method for securing CSEGs.
  
  
  OBJECTIVE
  To assess the efficacy and safety of polydioxanone absorbable plates used in primary and revision septorhinoplasty.
  
  
  METHODS
  We investigated all patients who underwent primary or revision septorhinoplasty with the use of absorbable plates to secure CSEGs at a tertiary academic medical center from 2010 to 2014. To standardize and objectify the symptoms of nasal obstruction, a validated quality-of-life instrument called the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, with 5 questions on a scale of 0 to 4, was implemented preoperatively and postoperatively. Preoperative and multiple successive postoperative measurements of nasal length and projection were taken using 3dMDvultus imaging software.
  
  
  METHODS
  Change in NOSE questionnaire score, change in nasal length and projection, and complications.
  
  
  RESULTS
  There were no absorbable plate-related complications in the 95 included patients. Comparing preoperative and postoperative NOSE questionnaire scores, there was a statistically significant improvement in all 5 categories: mean (SD) change of -1.42 (1.59) in congestion, -1.56 (1.53) in blockage or obstruction, -1.60 (1.54) in breathing through nose, -0.90 (1.54) in trouble sleeping, and -1.28 (1.46) in breathing during exercise (P < .001 for all) in the 50 patients with available data. In the 24 patients with greater than 180 days of follow-up, follow-up ranged from 183 to 717 days, and mean (SD) change in nasal length and projection was 0.64 (2.19) and 0.26 (0.96) mm, respectively, showing no statistically significant change over time (P = .17 and .21, respectively).
  
  
  CONCLUSIONS
  In our study population, nasal length and projection maintained position over time when absorbable plates were used to secure CSEGs. Absorbable plates appear safe and effective when used to secure CSEGs and limit the requirement of harvesting additional cartilage. Nasal airway improvement can be obtained when absorbable plates are used to secure CSEGs.
  
  
  METHODS
  4.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Illinois Hospital and Health Science System.
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Caughlin
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Illinois Hospital and Health Science System.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Been
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Illinois Hospital and Health Science System.
authors.forename: Ali Raad
authors.initials: AR
authors.lastname: Rashan
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Illinois Hospital and Health Science System2Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago.
authors.forename: Dean M
authors.initials: DM
authors.lastname: Toriumi
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000601:surgery; D009300:Nasal Septum / Q000601:surgery*; D016687:Polydioxanone; D011474:Prosthesis Design; D011788:Quality of Life; D012225:Rhinoplasty / Q000379:methods*; D011795:Surveys and Questionnaires; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D016687:Polydioxanone