A comparison of the tongue-in-groove and columellar strut in creating and maintaining tip projection and rotation: a randomized single blind trial

Abstract

Background

Rhinoplasty is one of the most challenging esthetic operations. The ability to achieve precise and predictable changes in the shape and position of the nasal tip is still among the demanding areas of rhinoplasty. Tongue in groove (TIG) and columellar strut are two of the many techniques to ensure an adequate nasal tip projection and rotation; however, there is little evidence to support long-term efficacy of these techniques.

Methods

In a clinical trial, 80 cases who were rhinoplasty candidates were studied prospectively. They were randomly divided into two groups according to the use of columellar strut and TIG. The outcome measures were gaining and maintaining tip projection and rotation in the long term. Standardized photographs before and 6 and 12 months after the surgery were the measurements to compare the results between the two groups, which were evaluated for nasolabial angle and projection. Also, the patients' satisfaction with beauty and nasal obstruction were assessed using the VAS (Visual Analogue Scale).

Results

Forty patients were operated using the columellar strut technique while the TIG method was used in 40 cases. Preoperatively, tip rotation, tip projection, and other characteristics were not significantly different between the two groups. Postoperatively, the patients' esthetic satisfaction was significantly greater in the TIG group 6 and 12 months after the surgery (P value = 0.001). The rest of the evaluated variables did not have any significant differences between the two groups.

Conclusions

It seems that both columellar strut and tongue in groove methods are effective techniques in maintaining tip projection and/or rotation in rhinoplasty. Using the tongue in groove technique in qualified hands may give significantly better esthetic satisfaction to patients than the columellar strut technique.

Level of evidence: Level I, therapeutic study.

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