Comparing the efficacy of lateral crural overlay versus transposition technique on cephalic malposition in septorhinoplasty

Abstract

Cephalic malposition is an anatomical variant that is found particularly in Middle Eastern people. Malpositioning of the alar cartilage may cause both functional and aesthetic problems. This study aimed to investigate and compare the functional and aesthetic outcomes of the two techniques used to correct cephalic malposition of the lower lateral cartilage: lateral crural overlay (LCO) and lateral crural transposition. This current randomised double-blinded clinical trial was performed on 40 patients who were referred for rhinoplasty in 2017-2018. They were randomly divided into two groups, the lateral crural transposition group (n = 20), and the LCO group (n = 20). The angle between the lateral crura and the midline, nasal rotation, nasal tip projection, nasal axis deviation, columella labial angle, and nasofacial angle, plus a visual analogue scale (VAS) and the 10-item Standardised Cosmesis and Health Nasal Outcomes Survey (SCHNOS), were assessed for each patient before surgery and after 12 months, and further compared between the two groups. Both techniques successfully improved the lateral crural angle, nasal tip rotation, and columella labial angle (p < 0.05). Despite the satisfactory outcomes of the VAS and SCHNOS based on both the patients' and the surgeons' opinions (p < 0.05), comparison of the indices revealed insignificant differences between the two groups (p> 0.05). We obtained successful aesthetic and functional outcomes with both techniques.