الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This study describes a new process of rhinoplasty, which integrates 3D printing. We established a procedure based on computer-aided design to generate a 3D model of customized nasal guide. The nasal tip is an important structure for the aesthetics and function of the nose. The definition of the nasal tip is often outlined as the region overlying the medial and lateral crura of the lower lateral cartilages. No studies, to our knowledge, have compared surgeons‘ qualitative assessments of tip support. Our study demonstrates that 3-D–printed nasal models can be used to quantify the minimum and ideal requirements for grafting for nasal tip support. Reconstruction of the ala and nostril, especially in cleft lip nasal deformity often results in patient dissatisfaction and postoperative asymmetry of both sides. As regard of removal of dorsal hump patient specific model to remove dorsal humps in rhinoplasty which can be reached by 3D CTimaging, nasal anthropometries. We provided basal, final and profile guides, which enabled us to manage dorsal hump. Therefore, this study evaluated the use and efficacy of preoperative 3Dvirtual simulation and surgical planning in rhinoplasty. This randomized clinical trial was conducted on 30 patients in the Plastic and Reconstructive Surgery Department of Tanta University during the period from December 2019 to July 2022. Patients were randomly divided according to the sequence of their hospital admission into two equal groups: • group A: Conventional-procedure rhinoplasty. • group B: Rhinoplasty with preoperative 3D-simulation. There was no significant difference between two groups as regard:- • Baseline characteristics (age, gender, and precious surgical operations) between the studied groups. • Regarding frontal view, there was no significant difference in bony base and alar base width in males between CT findings and virtual planning, but bony base and alar base width in females in CT findings were significantly higher than virtual planning in patients undergoing rhinoplasty with preoperative 3D-simulation. • Regarding lateral view, there was no significant difference in tip rotation in males, nasofrontal angle in males, nasal length in females, Tip projection in males and females between CT findings and virtual planning, but tip rotation and nasofrontal angle in females were significantly higher in virtual planning compared to CT findings and nasal length in males were significantly lower in virtual planning compared to CT findings. • Regarding basal view, there was no significant difference in alar base width in males and tip projection in males and females between CT findings and virtual planning, but alar base width in females and alar flaring were significantly higher in CT finding compared to virtual planning. • Types of patients‘ complaints: In group A, 8 (53%) patients were looking for an aesthetic improvement of the nose while 7 (47%) patients complained of combined of aesthetic and functional problems. In group B, 10 (67%) patients were looking for an aesthetic improvement of the nose while 5 (33%) patients complained of combined aesthetic and functional problems. • Patient‘s aesthetic complaints between the studied groups. Our results showed :- 1. Surgical time was significantly higher in group A than group B (p <0.001). 2. There was no significant difference in complications between the studied groups. 3. There was no significant difference in the average objective evaluation of the rhinoplasty performed by the assessment of three specialists. 4. There was a significant agreement between the 3 raters in group B, there was a moderate agreement between rater 1 and 2 (κ =0.413, p =0.016), between rater 1 and 3 (κ =0.478, p=0.006) and between rater 2 and 3 (κ =0.423, p =0.019). 5. The ROE questionnaire in the studied groups after 3 months showed that patients who were satisfied with the look of their nose, think that their friend like their nose, think that the appearance of their nose don‘t hamper their activities, think their nose looks as good as it could be, and don‘t want to undergo another surgery were significantly higher in group B than in group A. 6. There was no significant difference in breathing from nose between the studied groups. 7. There was no significant difference in functional score between the studied groups (p =0.061). 8. The aesthetic score was significantly higher in group B than group A (p < 0.0001). 9. Percentage of patient satisfaction based on ROE questionnaire was significantly higher in group B than group A (p <0.001).