Lateral Crural Steal With Columellar Strut Graft in Primary Open Rhinoplasty (LCS/CS)

January 8, 2026 updated by: Ahmed Elsaeed Habib, Kafrelsheikh University

The Effect of Lateral Crural Steal With Columellar Strut Graft on Nasal Tip Projection and Rotation in Primary Open Rhinoplasty

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.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Rhinoplasty is one of the most commonly performed aesthetic procedures worldwide, with the nasal tip being the most challenging aspect of it. The nasal tip represents the most anterior projecting point of the nose and is formed by the junction of the medial and lateral crura of lower lateral cartilages.

Projection, rotation, and definition are key aspects to be controlled and achieved in the nasal tip surgery. Preservation of natural tip support is a fundamental requirement of a successful rhinoplasty.

Although excisional techniques can produce reductions in lobular width, long-term contour alterations are unpredictable and subject to stigmatic tip deformity. As a consequence, aggressive excision-based techniques are increasingly recognized as haphazard, unpredictable, and disproportionately prone to undesirable postoperative contour deformities.

The lateral crural steal (LCS) is a tissue-conservative technique of nasal tip refinement through relocation of domal apices. Hence, modifying nasal tip projection and rotation. However, the long-term stability of tip position with LCS alone can be variable. To enhance support and long-term maintenance of tip projection, a columellar strut graft -placed between the medial crura- acts as a central scaffold, unifying the nasal tip and helping to control the final nasal tip position.

The lateral crural steal technique alone can achieve improvements in nasal tip projection and rotation, but with weak medial crura, it can twist or compress down the medial crura, which will result in loss of tip height. So, in the technique being studied, combining the LCS with a columellar strut graft can provide both dynamic and static support to the nasal tip.

Study Type

Interventional

Enrollment (Estimated)

22

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Egypt
      • Kafr ash Shaykh, Egypt, 33511
        • Recruiting
        • Kafrelsheikh University Hospital
        • Contact:
        • Principal Investigator:
          • Ahmed Elsaeed Habib

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • 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.

Exclusion Criteria:

  • 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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Primary Open Rhinoplasty
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
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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Nasal tip projection.
Time Frame: Analysis will be done preoperatively, immediate postoperatively, and at 6-month and 1-year postoperatively.

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

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 Outcome Measures

Outcome Measure
Measure Description
Time Frame
Patient's satisfaction
Time Frame: The questionnaire will be conducted pre-operatively (as a baseline), 3-month and 1-year postoperatively.
Assessing patient satisfaction through Rhinoplasty Outcome Evaluation (ROE) Questionnaire; which is a six-question questionnaire used to assess satisfaction with aesthetic and functional results after Rhinoplasty. Each of the six items is scored on a 0-4 scale, with 0 representing the most negative response and 4 representing the most positive response. Therefore, the total score can vary from 0 to 24. In order to facilitate the comprehension of the results, the total score can be divided by 24 and multiplied by 100, so that the score can vary from 0 to 100 %. So, 24 points or 100 % means the most patient satisfaction. It's originally piloted by Alsarraf (2000). The questionnaire has an Arabic-translated version done by Alharethy S, et al. (2021) that will be used.
The questionnaire will be conducted pre-operatively (as a baseline), 3-month and 1-year postoperatively.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Kafrelsheikh University

Investigators

  • Study Director: Safwat Adel Hegazy, Kafrelsheikh University
  • Study Chair: Khaled Ahmed Ismail, Kafrelsheikh University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 5, 2026

Primary Completion (Estimated)

January 1, 2027

Study Completion (Estimated)

February 1, 2027

Study Registration Dates

First Submitted

December 19, 2025

First Submitted That Met QC Criteria

December 19, 2025

First Posted (Estimated)

January 5, 2026

Study Record Updates

Last Update Posted (Actual)

January 9, 2026

Last Update Submitted That Met QC Criteria

January 8, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • KFSIRB200-725

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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