Abstract
Objectives:
(1) Discuss relevant tip projection ratios involved in surgical planning of rhinoplasty. (2) Implement findings of meta-analysis in cosmetic surgery planning.
Methods:
Meta-analysis of journal articles through June 2013. Intervention: Cosmetic rhinoplasty for underprojected tip. Outcome Measurements: Pre- and postoperative Goode Ratio in cosmetic rhinoplasty patients. Null hypothesis: None of 3 techniques provides superior tip projection among: suture, internal graft, and external graft.
Results:
External graft techniques, such as Sheen shield grafting, were found to significantly increase tip projection over suture only techniques. External vs suture: P = .017. (2) Internal graft techniques, such as columellar strut grafting, approached significance in increased tip projection over suture only technique. Internal vs suture: P = .053. (3) Internal and external graft techniques did not differ significantly, but external graft techniques displayed a tendency to increase tip projection more. External vs internal: P = .360.
Conclusions:
(1) Meta-analysis of the Goode Ratio has never been reported in the literature. (2) No technique has been proven to have significance in the past. (3) External grafts produce a significant change in nasal tip projection over suturing, and internal grafts approach significance. (4) This research allows the surgeon to rank techniques in order of magnitude of change desired.
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