A novel method for nasal dorsal reconstruction: permanent fixation using Kirschner wire-guided hidden sutures.
BACKGROUND
In this study, we aimed to present a novel application and use of Kirschner wire-guided suturing that is less invasive and allows permanent fixation for nasal dorsal reconstruction.


METHODS
A total of 23 patients, who underwent surgery between 2009 and 2013, were included in this study: 19 with saddle nose deformity and 4 patients with keystone area damage, or collapse of the dorsal nasal support during primary septoplasty or rhinoplasty. The patients were asked to fill out a nasal obstruction symptom evaluation (NOSE) scale preoperatively and at the postoperative sixth month to assess breathing quality. The patients were followed up for complications such as nasal dorsal contour irregularity, dorsal collapse, as well as graft malposition and infections. The results of the surgeries were assessed on the basis of preoperative and postoperative examinations, septal support test, NOSE scale results, and photographic comparison.


RESULTS
The mean (SD) NOSE scales were 78.91 (10.09) and 30.48 (10.71) in the preoperative and postoperative periods, respectively. The difference of mean NOSE scale was statistically significant (P < 0.001). None of the patients experienced nasal dorsal collapse or graft malposition. Two patients had nasal dorsal irregularity complaints owing to inadequate costal cartilage edge beveling. None of the patients had complications of suture reaction, suture visibility, or suture extrusion. All of the patients stated that they were happy with the cosmetic outcome.


CONCLUSIONS
Permanent sutures introduced through channels made with the Kirschner wire provide a less invasive, cosmetically pleasing, and functional solution, promising more reliable results in the long term.
*Department of Otorhinolaryngology, Faculty of Medicine, Sakarya University, Sakarya †Danbury Hospital, Danbury, CT ‡Department of Otolaryngology, Istanbul Surgery Hospital, Istanbul §Department of Otorhinolaryngology, Faculty of Medicine, Amasya University, Sakarya, Turkey.
Gurkan
G
Kayabasoglu
Alpen
A
Nacar
Mahmut Sinan
MS
Yilmaz
Aytug
A
Altundag
Melih
M
Cayonu
Mehmet
M
Guven
D000328:Adult; D001864:Bone Wires; D066186:Costal Cartilage / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009667:Nose Deformities, Acquired / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods*; D013537:Sutures