Dorsal roof flap rhinoplasty: Updated results and a new classification of nasal dorsal deformity

Background

The dorsal roof flap (DRF) technique was developed as a modification of the retractable roof method, which is a variant of dorsal preservation (DP).

Objective

The paper aims to present new results of the DRF technique and dorsal deformity analysis created for the technique.

Methods

A total of 57 primary rhinoplasty patients treated with DRF technique between 2022–2023 years were included in the study. A dorsal deformity classification based on the anticipated amount of dorsal reduction, nasal bone shape, and hump content was used. According to the classification, the noses were categorized into 3 types. All data were obtained from patient records, computed tomography views, and pre-and postoperative photographs. Aesthetic and functional results were assessed pre-and postoperatively using a visual analog scale (VAS) (0–10, 0 points means very poor).

Results

The mean follow-up period was 10.1 ± 3.9 months. 23 cases were type 1, 14 were type 2, and 20 were type 3. The anticipated amount of dorsal reduction in type 1 was 2–4 mm, 5–7 mm in type 2, and 8–10 mm in type 3 deformity. Of the total, 27 cases had a V-shaped nasal bone and 30 had an S-shaped. The hump composition was cartilaginous in 13 cases and bone and cartilage in 44 cases. Pre- and postoperative aesthetic and functional VAS scores were significantly different (p ≤ 0.001). No complications and therefore no revisions were observed during the follow-up period.

Conclusion

It is a versatile method to reshape the nasal dorsum and minimize the revisions associated with dorsal preservation when used in appropriate cases.