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Background <p>Saddle nose deformity results from loss of septal support leading to depression of the nasal dorsum and poor definition of dorsal aesthetic lines. Various grafting techniques have been described to restore dorsal height and contour. This study aimed to evaluate the effectiveness of the Subdorsal Cantilever Graft (SDCG) technique in preserving the natural dorsal aesthetic lines compared with the conventional dorsal onlay graft in patients with mild to moderate saddle nose deformity.</p> Methods <p>This controlled clinical trial involved 40 patients with mild to moderate saddle nose deformity treated at the Otorhinolaryngology Department—Tanta University Hospitals. Patients were allocated sequentially into two equal groups: Group I underwent conventional dorsal onlay costal cartilage grafting, while Group II underwent reconstruction using the subdorsal cantilever graft technique. Postoperative evaluation included clinical assessment, standardized photographs, objective measurements using Rhinobase software, and patient satisfaction using the Rhinoplasty Outcome Evaluation (ROE) questionnaire. Follow-up was conducted for 6 months.</p> Results <p>Refinement of dorsal aesthetic lines was significantly better in the subdorsal cantilever graft group compared with the conventional dorsal graft group (<i>P</i> &lt; 0.001).</p> <p>No cases of clinically evident graft resorption were observed in the SDCG group during the follow-up period, whereas graft resorption occurred in 20% of patients in the conventional graft group (<i>P</i> &lt; 0.001). There was no statistically significant difference between the two groups regarding graft deformity, graft displacement, or graft visibility. Patient satisfaction scores were significantly higher in the SDCG group.</p> Conclusions <p>The Subdorsal Cantilever Graft provides stable dorsal support and allows preservation of the natural dorsal contour in patients with mild to moderate saddle nose deformity. Within the limitations of this study, the technique demonstrated lower rates of graft resorption and improved aesthetic outcomes compared with conventional dorsal onlay grafting.</p>

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Autologous subdorsal cantilever graft versus dorsal costal cartilage graft in nasal dorsum reconstruction

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  • 发表日期：

    2026年4月20日

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  • Emadeldin Aboelazm,
  • Mohamed Nasser Elsheikh,
  • Hossam Elsherif,
  • Ahmed Elguindy,
  • Mohamed Elkady,
  • Mohamed Kassem,
  • Ahmed Khattab

摘要

Background

Saddle nose deformity results from loss of septal support leading to depression of the nasal dorsum and poor definition of dorsal aesthetic lines. Various grafting techniques have been described to restore dorsal height and contour. This study aimed to evaluate the effectiveness of the Subdorsal Cantilever Graft (SDCG) technique in preserving the natural dorsal aesthetic lines compared with the conventional dorsal onlay graft in patients with mild to moderate saddle nose deformity.

Methods

This controlled clinical trial involved 40 patients with mild to moderate saddle nose deformity treated at the Otorhinolaryngology Department—Tanta University Hospitals. Patients were allocated sequentially into two equal groups: Group I underwent conventional dorsal onlay costal cartilage grafting, while Group II underwent reconstruction using the subdorsal cantilever graft technique. Postoperative evaluation included clinical assessment, standardized photographs, objective measurements using Rhinobase software, and patient satisfaction using the Rhinoplasty Outcome Evaluation (ROE) questionnaire. Follow-up was conducted for 6 months.

Results

Refinement of dorsal aesthetic lines was significantly better in the subdorsal cantilever graft group compared with the conventional dorsal graft group (P < 0.001).

No cases of clinically evident graft resorption were observed in the SDCG group during the follow-up period, whereas graft resorption occurred in 20% of patients in the conventional graft group (P < 0.001). There was no statistically significant difference between the two groups regarding graft deformity, graft displacement, or graft visibility. Patient satisfaction scores were significantly higher in the SDCG group.

Conclusions

The Subdorsal Cantilever Graft provides stable dorsal support and allows preservation of the natural dorsal contour in patients with mild to moderate saddle nose deformity. Within the limitations of this study, the technique demonstrated lower rates of graft resorption and improved aesthetic outcomes compared with conventional dorsal onlay grafting.