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6OLUME .UMBER s #OLUMELLAR 3TRUT 'RAFT IN 2HINOPLASTY
was no statistically significant difference between
morphed nasal tip projection and postoperative
nasal tip projection (Table 5). In the planned
increase in nasal tip projection cohort, the Pear-
son parametric correlation coefficient between
planned and actual changes in nasal tip projec-
tion was 0.781, which was indicative of a strong,
statistically significant correlation (
p
< 0.0001).
In the overall study population, both
morphed Goode ratio (0.66 ± 0.039) and post-
operative Goode ratio (0.67 ± 0.039) were sig-
nificantly higher than preoperative Goode ratio
(0.61 ± 0.048) (
p
< 0.0001). Postoperative Goode
ratio was also higher than morphed Goode ratio
(0.67 versus 0.66) (
p
< 0.0001); this difference
was interpreted as a desirable shift toward the
ideal nasal projection/length proportion of 2:3
(0.67) (Table 6). In the overall study population,
both morphed nasolabial angle (101.5 ± 6.1) and
postoperative nasolabial angle (101.5 ± 6.7) were
statistically significantly higher than the preopera-
tive nasolabial angle (92.4 ± 10.3) (
p
< 0.0001). As
seen with tip projection, there was no statistically
significant difference between morphed naso-
labial angle and postoperative nasolabial angle
(Table 7).
Three patients (3 percent) in our series had
minor columellar contour irregularities (Fig. 3).
None of these patients belong to the planned
increase in nasal tip projection cohort. Two of
these patients underwent a columellar revision
procedure that was performed under local anes-
thesia. Columellar irregularities were successfully
corrected by revising transcolumellar scars and by
using short columellar strut grafts. Two patients
in our series had revisions for reasons other than
columellar deformities, including one unilateral
vestibular V-Y procedure for correction of alar
asymmetry and one revision of right lateral oste-
otomy. The total revision rate was 4 percent, and
all revisions were performed after obtaining the
late postoperative photographs.
Of 100 patients, 92 responded to the postop-
erative survey. Patients were asked to rate their
current satisfaction with the functional elastic-
ity of their nose during (1) activities of personal
hygiene such as cleaning and wiping, and (2)
activities of social interaction such as kissing
and smiling on a scale from 1 (not satisfied) to 5
(extremely satisfied). The average score of satis-
faction during activities of personal hygiene was
4.5, and the average score of satisfaction during
activities of social interaction was 4.8
DISCUSSION
In the normal nasal anatomy, an anterior
septal angle of sufficient height keeps the feet
of the medial crura off the anterior nasal spine;
the medial crura do not bear a significant load;
Table 4. Repeated Measures Analysis of Variance, Nasal Tip Projection, Overall Study Population*
(I) Time
(J) Time
Mean Difference (I − J)
p
†
Preoperative NTP (211.2 ± 37.7),
n
= 100
Morphed NTP
0.790
1.000
Postoperative NTP
−1.880
0.124
Morphed NTP (210.4 ± 35.7),
n
= 100
Preoperative NTP
−0.790
1.000
Postoperative NTP
−2.670‡
0.002‡
Postoperative NTP (213.1 ± 37.4),
n
= 100
Preoperative NTP
1.880
0.124
Morphed NTP
2.670‡
0.002‡
NTP, nasal tip projection.
*Descriptive statistics and pairwise comparisons, based on estimated marginal means.
†Bonferroni adjustment for multiple comparisons.
‡The mean difference is significant at the 0.05 level.
Table 5. Repeated Measures Analysis of Variance, Nasal Tip Projection, and Planned Increase in the Nasal Tip
Projection Cohort*
(I) Time
(J) Time
Mean Difference (I − J)
p
†
Preoperative NTP (204.8 ± 45.9),
n
= 32
Morphed NTP
−7.791‡
0.0001‡
Postoperative NTP
−9.684‡
0.0001‡
Morphed NTP (212.6 ± 45.3),
n
= 32
Preoperative NTP
7.791‡
0.0001‡
Postoperative NTP
−1.894
0.074
Postoperative NTP (214.5 ± 45.8),
n
= 32
Preoperative NTP
9.684‡
0.0001‡
Morphed NTP
1.894
0.074
NTP, nasal tip projection.
*Descriptive statistics and pairwise comparisons, based on estimated marginal means.
†With Bonferroni adjustment for multiple comparisons.
‡The mean difference is significant at the 0.05 level.