title: Redefining the Septal L-Strut to Prevent Collapse.
abstract: During septorhinoplasty, septal cartilage is frequently resected for various purposes but the L-strut is preserved. Numerous materials are inserted into the nasal dorsum during dorsal augmenation rhinoplasty without considering nasal structural safety. This study used a finite element method (FEM) to redefine the septal L-strut, to prevent collapse as pressure moved from the rhinion to the supratip breakpoint on the nasal dorsum and as the contact percentage between the caudal L-strut and the maxillary crest changed. We designed a 1-cm-wide L-strut model based on computed tomography data. At least 45% of the width of the L-strut in the inferior portion of the caudal strut must be preserved during septoplasty to stabilize the septum. In augmentation rhinoplasty, the caudal L-strut must either be preserved perfectly or reinforced to prevent collapse or distortion of the L-strut. The dorsal augmentation material must be fixed in an augmentation pocket to prevent movement of graft material toward the supratip breakpoint, which can disrupt the L-strut. We conducted a numerical analysis using a FEM to predict tissue/organ behavior and to help clinicians understand the reasons for target tissue/organ collapse and deformation.
authors.affiliation: Department of Mechanical Engineering, POSTECH, Pohang, Korea.
authors.forename: Jung-Seob
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, Korea.
authors.forename: Dong Chang
authors.initials: DC
authors.lastname: Lee
authors.affiliation: Department of Mechanical Engineering, POSTECH, Pohang, Korea.
authors.forename: Dong-Heon
authors.initials: DH
authors.lastname: Ha
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, Korea.
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Mechanical Engineering, POSTECH, Pohang, Korea.
authors.forename: Dong-Woo
authors.initials: DW
authors.lastname: Cho
mesh_terms: D006801:Humans; D055171:Nasal Cartilages / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D012225:Rhinoplasty / Q000379:methods*