Lamb Head as a Training Model for Septoplasty and Rhinoplasty.

Septoplasty and rhinoplasty are difficult operations to learn and teach. Many modalities have been proposed to make the teaching process of these operations easier. In this study, it was investigated if lamb heads were good training models to teach septoplasty and rhinoplasty to trainees or experienced surgeons. In the first part of the study, 21 lamb heads were dissected according to a dissection protocol and several anatomical distances were measured to compare them with human cadavers. In the second part, eight lamb heads were dissected and different preservation rhinoplasty techniques were practiced. The study on 21 lamb heads used showed that the lateral crura were 17.8 × 11.6, the average interdomal distance was 8.1 mm, and the average domal width was 3.7 mm. The average length of the upper lateral cartilages was 31.1 mm laterally and 21.2 medially. The average length of the nasal bones was 63.9 mm, and the width was 16 mm. In the second part of the study, 8 lamb heads were used to experience where high-strip techniques were used in 5 and the Cottle technique in 3. This study revealed that lamb heads should be considered as an excellent training model for septoplasty and rhinoplasty. Its very low cost, ease of availability, and close similarity to the human cadavers can be counted as the main advantages. This study also proved that it was not only a tool for beginners, but also a very helpful tool for experienced surgeons to try new methods.

L-Strut Graft: A Very Versatile Graft in the Management of Crooked and Traumatic Noses.

Importance: Numerous techniques have been described on the correction of nasal septum in crooked nose or badly deviated septum. To our knowledge, no previous study has been published solely on the value of using an L-strut graft for straightening the nasal septum. Objective: To investigate the use of L-strut graft technique for septal reconstruction in patients with a crooked nose or badly deviated septum. Design: A retrospective study was performed in patients with crooked nose or badly deviated septum who underwent correction by using an L-strut graft from the 1st of January 2000 to 1st of May 2019 at a tertiary referral center and a private hospital by the senior author. Intervention: All patients with crooked noses or badly deviated septums who underwent L-strut graft repair were taken into the study group. Main Outcomes and Measures: Straightening the deviated septum was the primary outcome. Secondary outcomes were getting rid of crookedness: mean deviation angles and distances from the midline in perioperative/postoperative pictures in three main landmarks: rhinion, supratip, and tip; and resolution of presenting symptoms of nasal obstruction. Results: One hundred nineteen patients were included: 65 men and 54 women (mean age 30.7 years). Septorhinoplasty was performed in 71 and septoplasty in 48 cases. The material for L-strut graft was cartilaginous in 100, bony cartilaginous in 11, and bony in 8 patients. The pictures of 21 rhinoplasty patients (10 women and 11 men; mean age 33.48 years) were uploaded into Rhinobase 1.1 for measurements. There was a decrease in the mean and median values in all measurements from the midline between pre- and postoperative measurements. Conclusions: In selected cases of crooked and traumatic noses, the L-strut graft can be helpful to splint and correct the deviated L-strut framework and it can act as a caudal septal extension graft to support the tip.