title: Aesthetic and Functional Results of Lateral Crural Repositioning.
abstract: OBJECTIVE
  Thin or cephalically malpositioned lateral crura cause nasal obstruction by depressing nasal valves and decrease patient satisfaction with rhinoplasty as a result of nostril asymmetry and alar collapse.
  
  
  OBJECTIVE
  To demonstrate the aesthetic and functional efficacy of lateral crural repositioning with lateral strut grafting in patients with cephalic malposition of the lateral crura undergoing primary septorhinoplasty.
  
  
  METHODS
  We prospectively selected 80 patients with lateral crural malposition who underwent primary septorhinoplasty performed by the same surgeon from December 1, 2013, through May 30, 2014. The surgeon measured the angle between the lateral crura and midline intraoperatively with a goniometer to confirm malposition (angle, ≤30°). Data analysis was performed from March 13 to 23, 2015.
  
  
  METHODS
  All the patients underwent primary rhinoplasty with the open approach. Lateral crural repositioning with lateral crural strut graft was used in all selected patients.
  
  
  METHODS
  Preoperative and 6- and approximately 12-month postoperative scores on the Nasal Obstruction Symptom Evaluation (NOSE) scale (range, 0-20; decreased scores indicate improved functional results) and the Rhinoplasty Outcomes Evaluation (ROE) questionnaire (range, 0-24; increased scores indicate improved aesthetic results).
  
  
  RESULTS
  Seventy-five of 80 patients were confirmed to have cephalic malposition intraoperatively. Four patients were excluded owing to selection of different surgical techniques, leaving 71 patients for analysis. The mean (SD) and median postoperative NOSE scores at 6 months (3.18 [3.12] and 2.0) and 12 months (0.39 [1.07] and 0) showed significant improvement compared with the preoperative scores (6.96 [5.10] and 7.0) (P < .01 for each comparison). The mean (SD) and median postoperative ROE scores also showed significant improvement at 6 months (21.06 [3.82] and 23.0) and 12 months (23.12 [2.09] and 24.0) compared with preoperative scores (7.03 [3.70] and 6.0) (P = .001). However, the changes from preoperative to 12-month postoperative scores (mean [SD] and median) were not significantly different between patients with normal (NOSE scores, 8.41 [4.59] and 90 to 0.28 [0.79] and 0, respectively; ROE scores, 6.97 [3.24] and 6.0 to 23.31 [1.91] and 24.0, respectively) and thin (NOSE score, 6.59 [5.09] and 8.0 to 0.11 [0.33] and 0, respectively; ROE scores, 7.76 [3.82] and 7.0 to 23.29 [1.72] and 24.0, respectively) skin types and those with thick skin types (NOSE scores, 5.52 [5.42] and 4.0 to 0.72 [1.54] and 0, respectively; ROE scores, 6.60 [4.16] and 6.0 to 22.80 [2.53] and 24.0, respectively) (P > .05).
  
  
  CONCLUSIONS
  Lateral crural repositioning is a useful and versatile technique to achieve successful functional and aesthetic results in a 1-year follow-up. We detected no significant difference by skin type in improvement of nasal function and aesthetic satisfaction.
  
  
  METHODS
  3.
authors.affiliation: Rinocenter, Istanbul, Turkey.
authors.forename: A Emre
authors.initials: AE
authors.lastname: Ilhan
authors.affiliation: Rinocenter, Istanbul, Turkey.
authors.forename: Betül
authors.initials: B
authors.lastname: Saribas
authors.affiliation: Rinocenter, Istanbul, Turkey.
authors.forename: Basak
authors.initials: B
authors.lastname: Caypinar
mesh_terms: D000293:Adolescent; D000328:Adult; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D055171:Nasal Cartilages / Q000601:surgery*; D015508:Nasal Obstruction / Q000601:surgery*; D011446:Prospective Studies; D020127:Recovery of Function; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome