Sonography of nasal tip anatomy and surgical tip refinement

The amorphous or wide nasal tip is the most commonly encountered nasal tip deformity, but little has been done to measure the effect of standard rhino plasty techniques on nasal tip width. In the clinical routine, nasal tip wi dth and soft-tissue cover thickness are estimated by inspection and palpati on rather than by measurement. In this study, a B-mode sonograph with a 12- MHz transducer was used in a noncontact mode to measure tip width 0.5 cm oc cipital to the tip defining point, distance between the alar cartilage dome s, and thickness of the soft-tissue cover overlying the lower lateral carti lages. These parameters were measured 3 to 8 weeks before and 56 days to 19 months after a transdomal suture tip plasty in 18 patients. The distance b etween the alar cartilage domes seemed to be an important factor for tip wi dth because interdomal distance, not soft-tissue cover thickness, correlate d with tip width before surgery (correlation: 0.53). Conversely, the degree of tip refinement correlated with preoperative soft-tissue cover thickness (correlation: 0.75), but not with interdomal distance. Ultrasonic imaging of nasal soft tissues may help to assess the effect of different tip refini ng procedures and other soft-tissue changes after rhinoplasty.