scholarly journals Bilateral congenital aplasia of nasal lower lateral cartilage: a rare anomaly

2020 ◽  
Vol 13 (1) ◽  
pp. e231905 ◽  
Author(s):  
Kapil Soni ◽  
Darwin Kaushal ◽  
Bikram Choudhury ◽  
Ranjit Kumar Sahu
Keyword(s):  
Septal Cartilage ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Difficulty Breathing ◽  
Aesthetic Results ◽  
Congenital Aplasia ◽  
Grafting Through ◽  
Cartilage Grafting ◽  
External Rhinoplasty

Congenital nasal anomalies are rare and occur in 1/20 000–1/40 000 newborns. An 8-year-old boy presented with developmental aplasia of bilateral nasal lower lateral cartilages, with excessive wrinkled and loose skin on the dorsum of the nose and with difficulty breathing through the nose. This is probably the first such case to be reported in the literature. The defect was reconstructed using conchal and septal cartilage grafting through an external rhinoplasty approach. At the end of the 12-month follow-up period, the patient was found to be satisfied with the functional and aesthetic results of the operation. Bilateral congenital aplasia of nasal lower lateral cartilages is extremely rare. Paediatric rhinoplasty is imperative in such cases.

Caudal Septoplasty for Treatment of C-Shaped Craniocaudal Deviation Using Synthetic Struts

2016 ◽  
Vol 34 (1) ◽  
pp. 50-54
Author(s):  
Daniel G. Moina ◽  
Gabriel Moina ◽  
Alberto Rancati
Keyword(s):  
Inferior Turbinate ◽  
Septal Cartilage ◽  
Septal Deviation ◽  
Functional Improvement ◽  
Aesthetic Results ◽  
The Mean ◽  
Cartilage Grafting ◽  
Pds Foil

We describe our technique using polydioxanone (PDS) foil for the correction and stabilization of caudal septal deviation. In addition, we evaluate the effectiveness of this technique in the treatment of the C-shaped craniocaudal sepal deviation. A retrospective review was conducted of 55 patients who underwent open septorhinoplasty with PDS splinting for the correction of a caudal septal deviation. The mean age was 35 years (range, 25-45 years), 38 of 55 (69%) were females and all had symptomatic nasal obstruction. Preoperatively, there were osteocartilaginous involvement and hypertrophy of the inferior turbinate at the opposite side of the septal deviation in all cases; whereas 30 (54.5%) patients had a bone spur, 20 (36.3%) had collapse of the external nasal valve due to septal deviation. Five patients complained of sinus headache that resolved after surgical correction. All patients were pleased with their functional improvement and 52 (95%) with their aesthetic results. Only 1 patient required surgical revision, which was due to the development of asymptomatic posterior septal perforation identified at follow-up endoscopy. There were no additional postoperative complications. Splinting of the septal cartilage with a PDS foil was feasible, safe, and effective for the treatment of severe caudal septal deviation. This technique emerges as an alternative to traditional cartilage grafting, especially in patients with insufficient cartilage for harvest or in patients with thin nasal dorsum in whom the use of a spreader graft can widen the nose and modify the normal nose contours, providing long-term support and stability of the septum.

Cleft Rhinoplasty: Strategies for the Multiply Operated Nose

2018 ◽  
Vol 34 (03) ◽  
pp. 290-297
Author(s):  
Tsung-yen Hsieh ◽  
Raj Dedhia ◽  
Travis Tollefson
Keyword(s):  
Surgical Procedure ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Nasal Deformity ◽  
Internal Lining ◽  
Cleft Rhinoplasty ◽  
Cartilage Grafting ◽  
Definition Of ◽  
Cleft Nasal Deformity ◽  
Maxillary Deficiency

AbstractRhinoplasty, as a surgical procedure to improve the appearance of the nose while preserving or improving function, is complicated and difficult to master. Revision cleft rhinoplasty offers another tier of challenge. The symmetry, proportions, and definition of the nose are affected by the native cleft deformity but also previous surgical scars, cartilage grafts, and skin excisions. Our preferred approach is to use structural cartilage grafting to establish septal and lower lateral cartilage resiliency. Internal lining deficiency is addressed with skin or lining transfer, while excess nasal tip thickness is contoured to improve definition. Of the utmost importance, the cleft nasal deformity cannot be considered in isolation, but rather a combined amalgamation of the lip muscle and scar, dentofacial occlusion, and skeletal maxillary deficiency.

S105 – Congenital Absence of the Left Lower Lateral Cartilage

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P112-P112 ◽  
Author(s):  
Kian Karimi ◽  
Robert T Adelson ◽  
Nicholas A Herrero
Keyword(s):  
Case Report ◽  
Congenital Abnormalities ◽  
Surgical Techniques ◽  
Nasal Airway ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Open Structure ◽  
Clinical Exam ◽  
Included Patient ◽  
Aesthetic Results

Objectives Review the embryology of the cartilaginous nasal skeleton. Present an anatomic varient of the nasal skeletal anatomy not previously described. Methods Case report of an adult patient evaluated for nasal airway obstruction and suspected from clinical exam to have absence of the left lower lateral cartilage. Photographs document this first report of an absent lower lateral cartilage and surgical techniques to reconstitute the nasal tip. Results Surgical outcome of open structure rhinoplasty and photographs included. Patient pleased with functional and aesthetic results of procedure. Conclusions This previously unreported clinical entity extends the spectrum of congenital abnormalities of the nose and can be addressed successfully with open structure rhinoplasty techniques.

The Deviated Nasal Tip: A Personal Technique for Correction Using Monolateral Crural Overlay and Monolateral Dome Truncation

2021 ◽  
Author(s):  
Tito M. Marianetti ◽  
Valentino Vellone ◽  
Valerio Ramieri ◽  
Francesca De Angelis
Keyword(s):  
Treatment Strategies ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Self Assessment ◽  
Nasal Tip ◽  
Novel Approach ◽  
High Satisfaction ◽  
Feasible Option ◽  
The Mean

Abstract Background To present a novel approach to correct nasal tip deviation with monolateral crural overlay or monolateral dome truncation, presenting as an isolated deformity or in complex nose deviations. Nasal tip deviation can be congenital or posttraumatic, due to a dislocated septum or cartilaginous septal or lower lateral cartilage malformations. Although some treatment strategies have been introduced, appropriate treatment remains a challenge because of the complexity and variability of such deformities. Methods It had been assumed that in most nasal tip deviations, a lower lateral cartilage was longer than the contralateral one. The authors analyzed 158 patients from January 2015 to October 2019 with nasal tip deviation and corrected the deviated tip by using a monolateral interruptive technique (lateral crural overlay or monolateral dome truncation) on the lower lateral cartilage. Photographic comparison between preoperative and at least 1-year follow-up for nasal axis deviation variable was analyzed and a self-assessment questionnaire was administrated to the patients at 1-year follow-up. Results The mean nasal deviation was 6.59° (±3.1°) preoperatively and 1.56° (±0.26°) postoperatively (p < 0.05). The range of differences between pre and postoperative deviations was 2.7° to 15.1°, and the mean difference was 6.1° (±3.21°). Of the 84 patients, 47 (55.95%) were very satisfied, 33 (39.28%) were satisfied, and 4 (4.76%) were unsatisfied with surgical the results and required revision surgery. Conclusions In authors' hands, monolateral interruptive techniques (lateral crural overlay or monolateral dome truncation) are a viable and feasible option to restore nasal tip symmetry. These techniques achieved high satisfaction rates among patients and resulted in reliable and reproducible symmetry immediately visible after surgery and stable over time (1-year postsurgery controls).

scholarly journals Alar Batten Grafts for Non-iatrogenic Nasal Valve Area/Alar Collapse

2009 ◽  
Vol 2 (3) ◽  
pp. 1-4 ◽  
Author(s):  
C Ekambar E Reddy ◽  
Trevor Teemul ◽  
Sucha Hampal ◽  
Krishna TV Reddy
Keyword(s):  
Nasal Obstruction ◽  
Septal Cartilage ◽  
Nasal Valve ◽  
Lower Lateral Cartilage ◽  
Modified Technique ◽  
Deviated Nasal Septum ◽  
Graft Size ◽  
Graft Extrusion ◽  
Valve Area

ABSTRACT Objectives We present our 3 years experience with alar batten grafts, using a modified technique, for non-iatrogenic nasal valve/alar collapse. Methods Retrospective (Oct. 2005 to Apr. 2008) and prospective study (Apr. 2008 to Dec. 2008) of 16 consecutive patients undergoing alar batten grafts for alar collapse causing nasal obstruction. The graft was inserted through a rim incision and placed across as well as superficial to the lower lateral cartilage. The main outcome measures were subjective improvement in nasal obstruction and absence of alar collapse at examination. Results Alar collapse was bilateral (n = 8), right sided (n = 4) and left sided (n = 4) giving 24 operated sides (s = 24). Deviated nasal septum (n = 9), synechiae (n = 1) and drooping tip (n = 1) were also present. Donor sites for the graft were septal cartilage (n = 10), conchal cartilage (n = 4) or both septal and conchal cartilages (n = 2). The median follow-up was 4 months (range 1 month to 3 years). Subjective nasal obstruction had worsened in 0%, was unchanged in 16.6% (s = 4), had improved in 16.6% (s = 4) and 66.6% (s = 16) were completely free of obstruction. Two of the improved cases worsened at 10 and 3 years giving overall failure in 25% (s = 6). Significant alar collapse was present in all failed cases and absence of collapse was documented in improved cases (s = 13). In failed cases the graft size width was 5 to 8 mm and in successful cases it was 10 to 15 mm. Lengths of the grafts in all cases was between 18 and 24 mm. One complication of graft extrusion through skin occurred. Conclusion Our technique of alar batten graft insertion appears to be as effective as other techniques described in the literature. We suggest a minimum graft size of 10 mm width and 18 mm length to improve success rate.

scholarly journals Alar cartilage hematoma of the nose secondary to facial trauma.

2021 ◽  
Vol 7 (11) ◽  
pp. 1817
Author(s):  
Nasir A. Magboul ◽  
Deafullah Al-Amri
Keyword(s):  
Road Traffic ◽  
Early Recognition ◽  
Rare Condition ◽  
Septal Cartilage ◽  
Alar Cartilage ◽  
Facial Trauma ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Intervention Patient ◽  
Nasal Bleeding

<p>A 27 years old male patient victim of road traffic accident presented to emergency department by ambulance team with ankle swelling and decrease range of motion, seen by orthopedic team and admitted as case of right ankle fracture for surgical intervention. Patient then referred to otolaryngology regarding on and off nasal bleeding and right nasal swelling arising from inner surface of right lower lateral cartilage of the nose 6 hour after the facial trauma, we present this case of hematoma of lower lateral cartilage which consider as one of the unique and rare condition following nasal and facial trauma. Early recognition of this condition is important, also differentiation between alar hematoma and septal cartilage hematoma is not easy for non-otolaryngology doctor, so increase awareness of this condition as one of possible sequel of fecal trauma and early referral to otolaryngology services is crucial. We present here a case of right sided alar cartilage hematoma, including the approach, management and follow up of the patient. We recommend early surgical drainage to optimize aesthetic out come after trauma.</p>

Caudal Extension Graft of the Lower Lateral Cartilage: Technique and Aesthetic and Functional Results

2021 ◽  
Author(s):  
Juliano de Oliveira Sales ◽  
Wolfgang Gubisch ◽  
Rodrigo Ribeiro Ferreira Duarte ◽  
Aline Souza Costa Teixeira Moreno ◽  
Felipe Marques de Oliveira ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Age Groups ◽  
Functional Results ◽  
First Year ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Alar Retraction ◽  
Outcomes Evaluation ◽  
A New Technique ◽  
Extension Graft

AbstractHere we describe a new technique to deal with alar retraction, a highly undesirable imperfection of the nose. The procedure involves placing a caudal extension graft below the vestibular portion of the lower lateral cartilage (LLC) after its detachment from the vestibular skin. The graft is fixed to the cartilage and, subsequently, to the vestibular tissue. The present retrospective study included 20 patients, 11 females and 9 males, with a mean age of 28.90 years. Follow-up ranged from 1 to 18 months. Surgery improved alar notching to a smoother dome shape and nostril exposure was reduced in every patient. The caudal extension graft of the LLC contributed to rise in overall patient satisfaction, as revealed by the postoperative increase of the Rhinoplasty Outcomes Evaluation (ROE) mean score from 40.0 to 79.17 (p < 0.0001). It also contributed to and improved functional outcomes, as indicated by the decrease of the Nasal Obstruction Symptom Evaluation (NOSE) mean score from 52.75 to 13.25 (p = 0.0001). Sex did not affect the mean ROE and NOSE scores. Thus, increased patient satisfaction measured by the ROE is present in both sexes and at both age groups but it is better detected in the first year after surgery. Functional improvements analyzed with NOSE are best detected in patients aged ≥ 30 years and in follow-ups of 11 months. The caudal extension graft of the LLC technique described herein effectively and safely corrects alar retraction and the collapse of the nasal valve while filling the soft triangle.

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