Effects of the Tongue-in-Groove Maneuver on Nasal Tip Rotation

Background: A change in nasal tip rotation is a very common maneuver performed during rhinoplasty. Among the many techniques used to achieve this goal is the tongue-in-groove (TIG). Objectives: This study addresses the long-term effect of the TIG on the nasal tip rotation 1 year after rhinoplasty. Methods: The authors prospectively identified patients who were submitted to a rhinoplasty with a TIG maneuver over a period of 1 year. The angle of rotation was measured along the nostril axis angle. The data were analyzed using the t test and a linear regression model. Results: Seventeen patients were included. The average preoperative tip rotation was 93.95 degrees (SD, 3.12 degrees). Immediate postoperative tip rotation averaged 114.47 degrees (SD, 3.79 degrees). At the 1-year follow-up appointment, the tip rotation averaged 106.55 degrees (SD, 3.54 degrees). There was a significant loss of rotation at the 1-year postoperative visit (P < 0.0001), with an average loss of 7.9 degrees (SD, 3.25 degrees), which amounted to 6.8%. The preoperative rotation didn't affect the amount of loss of rotation (P = 0.04). It can be estimated that, for every degree of rotation that is changed at surgery, the tip can be expected to lose 0.35 degrees over the first year. Conclusions: TIG is a more dependable technique than the ones that rely on healing and contraction to obtain rotation. Our data demonstrated a significant loss of rotation during the first year. This suggests that the surgeon needs to slightly overcorrect the tip rotation to account for this loss.