RhinoplastyLCS/CSNCT07317947
Lateral Crural Steal With Columellar Strut Graft in Primary Open Rhinoplasty
A study testing Lateral crural steal with columellar strut graft in Primary Open Rhinoplasty in people with Rhinoplasty and Nasal Surgery, run by Kafrelsheikh University at 1 site in Egypt.
Trial summary
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. Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- Rhinoplasty, Nasal Surgery, Aesthetic Outcomes
- What is being tested?
- Lateral crural steal with columellar strut graft in Primary Open Rhinoplasty
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 22 participants
- Where
- 1 siteEgypt
- Study dates
- 5 Jan 2026to Feb 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- 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.
Who cannot join
- 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.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site, 1 recruiting
- Recruiting
Kafrelsheikh University Hospital
Kafr ash Shaykh, 33511
Ahmed Elsaeed Habib, +201094661161, aelsaeid11@gmail.com
Ahmed Elsaeed Habib
About this study
Official title: 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.
Read the 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.
- Conditions
- Rhinoplasty, Nasal Surgery, Aesthetic Outcomes
- Being tested
- Lateral crural steal with columellar strut graft in Primary Open Rhinoplasty
- Keywords
- Rhinoplasty, Lateral crural steal, Columellar strut, Rhinobase, Rhinoplasty Outcome Evaluation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Lateral crural steal with columellar strut graft in Primary Open RhinoplastyProcedure or surgery
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.
| Study group | Role | What they receive |
|---|---|---|
| Primary Open Rhinoplasty | Experimental | Lateral crural steal with columellar strut graft will be done in patients undergoing Primary Open Rhinoplasty Receives: Procedure: Lateral crural steal with columellar strut graft in Primary Open Rhinoplasty |
What is being measured
The primary outcome is the main question the study is designed to answer.
Nasal tip projection.
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.
Measured: Analysis will be done preoperatively, immediate postoperatively, and at 6-month and 1-year postoperatively.
Nasal tip rotation
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.
Measured: Analysis will be done preoperatively, immediate postoperatively, and at 6-month and 1-year postoperatively.
Secondary outcomes (1)
Patient's satisfaction
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.
Measured: The questionnaire will be conducted pre-operatively (as a baseline), 3-month and 1-year postoperatively.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Jan 2026
- Study start5 Jan 2026
- Primary completionJan 2027 (estimated)
- Study completionFeb 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for RhinoplastyStudies of the same condition, open and under way.
- More trials run by Kafrelsheikh UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 22 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Kafrelsheikh University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Ahmed Elsaeed Habib, Kafrelsheikh University
- Investigators
- Safwat Adel Hegazy, Study director, Kafrelsheikh UniversityKhaled Ahmed Ismail, Study chair, Kafrelsheikh University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07317947
- Sponsor's protocol ID
- KFSIRB200-725
- Acronym
- LCS/CS
- Status last verified
- Jan 2026
- First submitted
- 19 Dec 2025
- Last updated
- 9 Jan 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Mulafikh DS, Alharethy SE, Alqabbani AA, Mesallam TA. Validation and clinical application of the Arabic rhinoplasty outcomes evaluation questionnaire. Saudi Med J. 2021 Jun;42(6):655-659. doi: 10.15537/smj.2021.42.6.20210038.
PubMed 34078728Alsarraf R. Outcomes research in facial plastic surgery: a review and new directions. Aesthetic Plast Surg. 2000 May-Jun;24(3):192-7. doi: 10.1007/s002660010031.
PubMed 10890946Apaydin F, Akyildiz S, Hecht DA, Toriumi DM. Rhinobase: a comprehensive database, facial analysis, and picture-archiving software for rhinoplasty. Arch Facial Plast Surg. 2009 May-Jun;11(3):209-11. doi: 10.1001/archfacial.2009.35. No abstract available.
PubMed 19451458Cetiner H. The Effect of Anchoring the Columellar Strut Graft to the Lateral Crural Steal Suture in Patients With a Low Nasal Tip: A New Technique. J Craniofac Surg. 2019 Mar/Apr;30(2):437-441. doi: 10.1097/SCS.0000000000005110.
PubMed 30614999Davis RE. Lateral crural tensioning for refinement of the wide and underprojected nasal tip: rethinking the lateral crural steal. Facial Plast Surg Clin North Am. 2015 Feb;23(1):23-53. doi: 10.1016/j.fsc.2014.09.003.
PubMed 25430927Kridel RW, Konior RJ, Shumrick KA, Wright WK. Advances in nasal tip surgery. The lateral crural steal. Arch Otolaryngol Head Neck Surg. 1989 Oct;115(10):1206-12. doi: 10.1001/archotol.1989.01860340060018.
PubMed 2789776Sepehr A, Alexander AJ, Chauhan N, Chan H, Adamson PA. Cephalic positioning of the lateral crura: implications for nasal tip-plasty. Arch Facial Plast Surg. 2010 Nov-Dec;12(6):379-84. doi: 10.1001/archfacial.2010.87.
PubMed 21079114Toriumi DM. New concepts in nasal tip contouring. Arch Facial Plast Surg. 2006 May-Jun;8(3):156-85. doi: 10.1001/archfaci.8.3.156.
PubMed 16702528Westreich RW, Lawson W. The tripod theory of nasal tip support revisited: the cantilevered spring model. Arch Facial Plast Surg. 2008 May-Jun;10(3):170-9. doi: 10.1001/archfaci.10.3.170.
PubMed 18490543Moubayed SP, Abou Chacra Z, Kridel RW, Ahmarani C, Rahal A. Precise anatomical study of rhinoplasty: description of a novel method and application to the lateral crural steal. JAMA Facial Plast Surg. 2014 Jan-Feb;16(1):25-30. doi: 10.1001/jamafacial.2013.1416.
PubMed 24177341
Study at a glance
From the registry record, last updated by the sponsor on 9 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Lateral Crural Steal With Columellar Strut Graft on Nasal Tip Projection and Rotation in Primary Open Rhinoplasty
- ClinicalTrials.gov ID
- NCT07317947
- Acronym / sponsor ID
- LCS/CS / KFSIRB200-725
- Conditions
- Rhinoplasty, Nasal Surgery, Aesthetic Outcomes
- Keywords
- Rhinoplasty, Lateral crural steal, Columellar strut, Rhinobase, Rhinoplasty Outcome Evaluation
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 22 participants (estimated)
- Lead sponsor
- Kafrelsheikh UniversityUniversity, hospital or other
- Study start
- 5 Jan 2026 (actual)
- Primary completion
- Jan 2027 (estimated)
- Study completion
- Feb 2027 (estimated)
- First posted
- 5 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
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 design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Primary Open Rhinoplasty | Experimental | Procedure: Lateral crural steal with columellar strut graft in Primary Open RhinoplastyLateral crural steal with columellar strut graft will be done in patients undergoing Primary Open Rhinoplasty |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- 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.
Key exclusion criteria (8 listed)
- 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.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Lateral crural steal with columellar strut graft in Primary Open RhinoplastyPatients 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. | Procedure or surgery | Primary Open Rhinoplasty |
Primary outcome
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.
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.
1 secondary outcome
Patient's satisfaction
Time frame: The questionnaire will be conducted pre-operatively (as a baseline), 3-month and 1-year postoperatively.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Jan 2026.
- Background: PubMed 34078728Mulafikh DS, Alharethy SE, Alqabbani AA, Mesallam TA. Validation and clinical application of the Arabic rhinoplasty outcomes evaluation questionnaire. Saudi Med J. 2021 Jun;42(6):655-659. doi: 10.15537/smj.2021.42.6.20210038.
- Background: PubMed 10890946Alsarraf R. Outcomes research in facial plastic surgery: a review and new directions. Aesthetic Plast Surg. 2000 May-Jun;24(3):192-7. doi: 10.1007/s002660010031.
- Background: PubMed 19451458Apaydin F, Akyildiz S, Hecht DA, Toriumi DM. Rhinobase: a comprehensive database, facial analysis, and picture-archiving software for rhinoplasty. Arch Facial Plast Surg. 2009 May-Jun;11(3):209-11. doi: 10.1001/archfacial.2009.35. No abstract available.
- Background: PubMed 30614999Cetiner H. The Effect of Anchoring the Columellar Strut Graft to the Lateral Crural Steal Suture in Patients With a Low Nasal Tip: A New Technique. J Craniofac Surg. 2019 Mar/Apr;30(2):437-441. doi: 10.1097/SCS.0000000000005110.
- Background: PubMed 25430927Davis RE. Lateral crural tensioning for refinement of the wide and underprojected nasal tip: rethinking the lateral crural steal. Facial Plast Surg Clin North Am. 2015 Feb;23(1):23-53. doi: 10.1016/j.fsc.2014.09.003.
- Background: PubMed 2789776Kridel RW, Konior RJ, Shumrick KA, Wright WK. Advances in nasal tip surgery. The lateral crural steal. Arch Otolaryngol Head Neck Surg. 1989 Oct;115(10):1206-12. doi: 10.1001/archotol.1989.01860340060018.
- Background: PubMed 21079114Sepehr A, Alexander AJ, Chauhan N, Chan H, Adamson PA. Cephalic positioning of the lateral crura: implications for nasal tip-plasty. Arch Facial Plast Surg. 2010 Nov-Dec;12(6):379-84. doi: 10.1001/archfacial.2010.87.
- Background: PubMed 16702528Toriumi DM. New concepts in nasal tip contouring. Arch Facial Plast Surg. 2006 May-Jun;8(3):156-85. doi: 10.1001/archfaci.8.3.156.
- Background: PubMed 18490543Westreich RW, Lawson W. The tripod theory of nasal tip support revisited: the cantilevered spring model. Arch Facial Plast Surg. 2008 May-Jun;10(3):170-9. doi: 10.1001/archfaci.10.3.170.
- Background: PubMed 24177341Moubayed SP, Abou Chacra Z, Kridel RW, Ahmarani C, Rahal A. Precise anatomical study of rhinoplasty: description of a novel method and application to the lateral crural steal. JAMA Facial Plast Surg. 2014 Jan-Feb;16(1):25-30. doi: 10.1001/jamafacial.2013.1416.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Safwat Adel Hegazy study director
Kafrelsheikh University
Khaled Ahmed Ismail study chair
Kafrelsheikh University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Lateral crural steal with columellar strut graft in Primary Open Rhinoplasty in people with Rhinoplasty and Nasal Surgery, run by Kafrelsheikh University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 9 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Ahmed Elsaeed Habib (+201094661161, aelsaeid11@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Nasal tip projection. (time frame: Analysis will be done preoperatively, immediate postoperatively, and at 6-month and 1-year postoperatively.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07317947, which also lists 10 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Jan 2026.