Lateral Crural Steal With Columellar Strut Graft in Primary Open Rhinoplasty

NCT07317947 | Recruiting

• 1 other identifier: KFSIRB200-725
• Study Type: interventional
• Target: 22
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to assess the effect of Lateral crural steal with Columellar strut graft done in Primary Open Rhinoplasty and its long-term sustainability on nasal tip projection and nasal tip rotation.

Conditions

Rhinoplasty; Nasal Surgery; Aesthetic Outcomes

Keywords

Rhinoplasty; Lateral crural steal; Columellar strut; Rhinobase; Rhinoplasty Outcome Evaluation

Outcome Measures

Primary Outcomes (2)

• Nasal tip projection.

  Assessing nasal projection using Goode's ratio, which is the ratio between distance from the alar crease (vertical plane of the alar base) to the tip of the nose and distance from the nasion to the tip of the nose. The ideal ratio is between 0.55 to 0.60. Nasal tip projection will be assessed using Rhinobase® software developed by Apaydin et al (2009), which is a software for rhinoplasty that enables standardized photographic analysis, facilitates precise anthropometric measurements, and provides objective documentation of pre- and postoperative nasal parameters.

  Analysis will be done preoperatively, immediate postoperatively, and at 6-month and 1-year postoperatively.

• Nasal tip rotation

  Assessing nasal tip rotation through measuring the Nasolabial angle which is the angle formed at the junction of the columella and a line drawn from the subnasale to the labrale superius, and the Nasofacial angle which is the angle between the nasal dorsum and the facial plane (glabella to pogonion). Nasal tip rotation will be assessed using Rhinobase® software developed by Apaydin et al (2009), which is a software for rhinoplasty that enables standardized photographic analysis, facilitates precise anthropometric measurements, and provides objective documentation of pre- and postoperative nasal parameters.

  Analysis will be done preoperatively, immediate postoperatively, and at 6-month and 1-year postoperatively.

Secondary Outcomes (1)

• Patient's satisfaction

  The questionnaire will be conducted pre-operatively (as a baseline), 3-month and 1-year postoperatively.

Study Arms (1)

Primary Open Rhinoplasty

EXPERIMENTAL

Lateral crural steal with columellar strut graft will be done in patients undergoing Primary Open Rhinoplasty

Procedure: Lateral crural steal with columellar strut graft in Primary Open Rhinoplasty

Interventions

Lateral crural steal with columellar strut graft in Primary Open Rhinoplasty PROCEDURE

Patients undergo primary open rhinoplasty under general anesthesia. After local infiltration, an open approach is performed using an inverted-V transcolumellar incision with bilateral marginal incisions. The skin-soft tissue envelope is elevated in the supra-perichondrial plane. Dorsal deformities are corrected and septoplasty is performed with cartilage harvest. Vestibular skin is undermined and cephalic trimming of the lateral crura is carried out. Lateral crural steal is performed by advancing the medial end of the lateral crus 3-5 mm medially using transdomal sutures after defining the new dome position. A fixed columellar strut graft is inserted between the medial crura and secured to provide central tip support. Interdomal sutures are placed. No additional projection-enhancing grafts are used. Incisions are closed and internal and external nasal splints are applied.

Primary Open Rhinoplasty

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients seeking primary rhinoplasty for aesthetic and/or functional indications.
• Presence of inadequate nasal tip projection and/or rotation suitable for correction using lateral crural steal with columellar strut graft.
• Ability to provide written informed consent and comply with follow-up visits.

You may not qualify if:

• History of prior nasal surgery.
• History of severe nasal trauma, altering cartilage architecture.
• Significant functional nasal obstruction requiring complex external nasal valve reconstruction.
• Patients with excessively wide alar base requiring alar base reduction involving vestibular sill excision (to prevent confounding on projection/rotation).
• Patients with facial skeletal or developmental abnormalities e.g. maxillary hypoplasia, maxillary prognathism, dentofacial deformities.
• Patients with psychiatric illness or Body Dysmorphic Disorder.
• Significant medical comorbidities contraindicating elective surgery or general anesthesia.
• Inability to provide informed consent or comply with follow-up.

Sponsors & Collaborators

• Kafrelsheikh University: lead

Study Sites (1)

Kafrelsheikh University Hospital

Kafr ash Shaykh, 33511, Egypt

RECRUITING

Related Publications (10)

• Mulafikh DS, Alharethy SE, Alqabbani AA, Mesallam TA. Validation and clinical application of the Arabic rhinoplasty outcomes evaluation questionnaire. Saudi Med J. 2021 Jun;42(6):655-659. doi: 10.15537/smj.2021.42.6.20210038.

  PMID: 34078728 BACKGROUND

• Alsarraf R. Outcomes research in facial plastic surgery: a review and new directions. Aesthetic Plast Surg. 2000 May-Jun;24(3):192-7. doi: 10.1007/s002660010031.

  PMID: 10890946 BACKGROUND

• Apaydin F, Akyildiz S, Hecht DA, Toriumi DM. Rhinobase: a comprehensive database, facial analysis, and picture-archiving software for rhinoplasty. Arch Facial Plast Surg. 2009 May-Jun;11(3):209-11. doi: 10.1001/archfacial.2009.35. No abstract available.

  PMID: 19451458 BACKGROUND

• Cetiner H. The Effect of Anchoring the Columellar Strut Graft to the Lateral Crural Steal Suture in Patients With a Low Nasal Tip: A New Technique. J Craniofac Surg. 2019 Mar/Apr;30(2):437-441. doi: 10.1097/SCS.0000000000005110.

  PMID: 30614999 BACKGROUND

• Davis RE. Lateral crural tensioning for refinement of the wide and underprojected nasal tip: rethinking the lateral crural steal. Facial Plast Surg Clin North Am. 2015 Feb;23(1):23-53. doi: 10.1016/j.fsc.2014.09.003.

  PMID: 25430927 BACKGROUND

• Kridel RW, Konior RJ, Shumrick KA, Wright WK. Advances in nasal tip surgery. The lateral crural steal. Arch Otolaryngol Head Neck Surg. 1989 Oct;115(10):1206-12. doi: 10.1001/archotol.1989.01860340060018.

  PMID: 2789776 BACKGROUND

• Sepehr A, Alexander AJ, Chauhan N, Chan H, Adamson PA. Cephalic positioning of the lateral crura: implications for nasal tip-plasty. Arch Facial Plast Surg. 2010 Nov-Dec;12(6):379-84. doi: 10.1001/archfacial.2010.87.

  PMID: 21079114 BACKGROUND

• Toriumi DM. New concepts in nasal tip contouring. Arch Facial Plast Surg. 2006 May-Jun;8(3):156-85. doi: 10.1001/archfaci.8.3.156.

  PMID: 16702528 BACKGROUND

• Westreich RW, Lawson W. The tripod theory of nasal tip support revisited: the cantilevered spring model. Arch Facial Plast Surg. 2008 May-Jun;10(3):170-9. doi: 10.1001/archfaci.10.3.170.

  PMID: 18490543 BACKGROUND

• Moubayed SP, Abou Chacra Z, Kridel RW, Ahmarani C, Rahal A. Precise anatomical study of rhinoplasty: description of a novel method and application to the lateral crural steal. JAMA Facial Plast Surg. 2014 Jan-Feb;16(1):25-30. doi: 10.1001/jamafacial.2013.1416.

  PMID: 24177341 BACKGROUND

Study Officials

• Safwat Adel Hegazy

  Kafrelsheikh University

  STUDY DIRECTOR

• Khaled Ahmed Ismail

  Kafrelsheikh University

  STUDY CHAIR

Central Study Contacts

Ahmed Elsaeed Habib

CONTACT

+201094661161; aelsaeid11@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Plastic Surgery Resident

Study Record Dates

• First Submitted: December 19, 2025
• First Posted: January 5, 2026
• Study Start: January 5, 2026
• Primary Completion (Estimated): January 1, 2027
• Study Completion (Estimated): February 1, 2027
• Last Updated: January 9, 2026

Record last verified: 2026-01

Locations

EG (1)