Lateral Crural Strut Grafts

Lower lateral crural strut grafts are a common method used by many surgeons to enhance tip shape, support and function. Most commonly they are used to fix external nasal valve collapse, internal nasal valve collapse and nasal tip bulbosity.

How do lower lateral crural strut grafts treat external valve collapse?

In some patients their lower lateral cartilages does not provide enough support of the external nasal valve and lateral nostril region. With inspiration there is collapse of the nostrils resulting in airflow obstruction.

Some patients also have a condition where the outer lower lateral cartilages curve inwards into the nasal airway blocking it. This condition, called “internal recurvature of the lower lateral cartilages” is effectively treated with lateral crural strut grafts.

Where are the lateral crura?

If you look at the diagram below you can see how the lower lateral crura provides a large portion of the nasal tip and sidewall support.

Lateral crura

Lateral crura profile view

What should the lower lateral crural look like?

There is no particular way that the lower lateral crural should look but if you look at the underlying structure of an aesthetically appealing tip you will notice the lower lateral cartilages are typically flat. The lower lateral crura play an important role in how the nose looks and functions. If the lower lateral crura are curved the tip will have a more bulbous appearance or if these cartilages are more concave the tip will appear more pinched.

How can you make the lower lateral crural flat?

Intra-domal sutures narrow the nasal tip but also help to flatten out the lateral crura. A cephalic trim may be necessary to make the crural cartilges more pliable. A lateral crural turn-in flap can be used when there is a large amount of alar cartilage available. Lateral crural strut grafts from septal or rib cartilage provide many advantages. Lateral crural strut grafts not only flatten the lateral crura but can also be used to reposition the cartilage and add strength to treat nasal valve collapse.

What are lower lateral crural struts made of?

Lower lateral crural struts are made up of a straight, relatively strong piece of cartilage (usually septal or rib) that is carved into a rectangular shape.

Lateral crural strut grafts