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Erschienen in:
06.12.2023 | Rhinology
The effect of subperichondrial dissection on nasal vascularity in septorhinoplasty operations
Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 4/2024
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Purpose
Nasal vascularization runs above the superficial musculoaponeurotic system (SMAS). Perichondrium covers the lower and upper lateral cartilages. In this study, nasal vascularization was compared between subperichondrial and supraperichondrial dissection in closed septorhinoplasty.
Methods
95 patients and 41 volunteers were included in this study. Supraperichondrial dissection was performed in 48 patients and subperichondrial dissection was performed in 47 patients. To measure blood stream, laser doppler flowmetry (LDF) was used and measurements were done preoperatively, on the postoperative first week; 3rd month and first year.
Results
The nasal tip and dorsum measurements were similar between the preoperative and postoperative first year in both groups (p = 1.000). However, in the supraperichondrial dissection group, nasal tip measurements showed a significant increase between the preoperative and third postoperative months (p = 0.011). This increase was accompanied by an increase in the minimal blood stream (p = 0.014).
Conclusion
Both subperichondrial and supraperichondrial dissection techniques are physiological and result in fewer complications with minimal permanent vascular damage. We believe incision plays a critical role but keeping the perichondrium intact is important for short-term angiogenesis, where long-term results showed no difference in vascularization.