Rhinoplasty to Correct Nasal Deformities in Postseptoplasty Patients

2009 ◽  
Vol 23 (5) ◽  
pp. 540-545 ◽  
Author(s):  
Nam-Kyung Yeo ◽  
Yong Ju Jang
Keyword(s):  
Surgical Approach ◽  
Costal Cartilage ◽  
Septal Cartilage ◽  
Surgical Correction ◽  
Saddle Nose ◽  
Nasal Deformity ◽  
Deviated Nose ◽  
Nasolabial Angle ◽  
External Nose ◽  
Before And After

Background Although not so common, septoplasty carries the risk of inducing nasal deformity such as saddle nose and deviated nose. Surgical correction for those deformities is a formidable task to deal with, because the septal cartilage framework was already weakened due to previous procedure. This study was designed to examine various causes and effective techniques of rhinoplasty for correction of nasal deformities after septoplasty. Methods Subjects comprised 19 patients who developed nasal deformities after septoplasty. Pre- and postoperative photographs were analyzed by two rhinoplastic surgeons. Anthropometric measurements of the external nose before and after surgery were made using frontal and lateral photographs to objectively evaluate outcomes. Results Intraoperative analysis showed that 5 patients had weak L-struts and 13 patients had displaced caudal septa. Septum was reconstructed using costal cartilage in 13 cases. Spreader grafting was performed in 13 patients and caudal septal extension grafts were performed in 10 patients. All but 1 patient had successful functional and esthetic outcomes. In the saddle nose group, all parameters except nasolabial angle were significantly improved. In the deviated nose group, curved deviated angles were completely corrected, whereas the linear deviated angle was not. Conclusion Loss of caudal septal support appears to be a major reason for nasal deformity after septoplasty. The best surgical approach for septal cartilage framework reconstruction appears to involve the use of bilateral spreader or septal extension grafts using costal cartilage.

Anthropometric Evaluation of Photographic Images Before and After Functional Nasal Surgery in Patients With Deviated Noses

2020 ◽  
pp. 194589242098311
Author(s):  
Joerg Lindemann ◽  
Franziska Stupp ◽  
Marc Scheithauer ◽  
Anna Schmadl ◽  
Eva Goldberg-Bockhorn ◽  
...  
Keyword(s):  
Facial Asymmetry ◽  
Nasal Surgery ◽  
Biometric Analysis ◽  
Photographic Images ◽  
Deviated Nose ◽  
Angle Measurements ◽  
External Nose ◽  
Before And After ◽  
Negative Effect

Background Numerous techniques for correction of deviated noses have been described. Nevertheless, surgical management is challenging even for experienced rhinosurgeons. Often, a “residual deformity” after functional septorhinoplasty (SRP) due to a deviated pyramid syndrome may remain. Objective Therefore, the purpose of this study was to determine how frequent functional SRP in patients with a deviated nose results in “successful” straightening of the external nose based on standardized angle measurements. Possible influences having a positive or negative effect on the surgical success were identified. Methods Photo documentation of 607 patients with deviated noses (304 women, 303 men, median age 30 years) before and after nasal surgery were retrospectively analyzed using standardized angle measurements. The pre- and postoperative photos of the faces were anthropometrically measured. The median follow-up was 6 months. Results A “straight” deviated nose (I-type) was present in 225 patients (37%), a C-shaped nose (C-type) in 382 patients (63%). More than 75% of the patients presented a facial asymmetry. Based on angle measurements alone, a total of 452 (75%) noses were straightened or postoperatively improved. 155 noses (25%) still showed a biometric deviation. The I- or C-type had no relevant influence on outcome. Conclusion A purely biometric analysis of crooked noses is difficult and its importance is limited due to commonly pre-existing facial asymmetries. The risk of a “residual deviation” after rhinoplasty in patients with deviated noses must not be underestimated. This fact should be addressed as part of the informed consent. In particular, it should be mentioned that the surgical outcome can remain well below the patient’s aesthetic expectations. Not rarely, a revision surgery may be necessary.

Clincal Study on Surgical Correction of Cleft Nasal Deformity

2018 ◽  
Vol 21 (1) ◽  
pp. 1-7
Author(s):  
Young-Kee Lee ◽  
◽  
Young-Wook Park ◽  
Keyword(s):  
Surgical Correction ◽  
Nasal Deformity ◽  
Cleft Nasal Deformity

scholarly journals The Deviated Nose and the Nasal Airway

1979 ◽  
Vol 72 (11) ◽  
pp. 848-851
Author(s):  
A G D Maran
Keyword(s):  
Airway Obstruction ◽  
Experimental Work ◽  
Septal Cartilage ◽  
Nasal Airway ◽  
Deviated Nose ◽  
Bony Segment ◽  
Submucous Resection ◽  
And Cartilage ◽  
Valve Area ◽  
Taking Care

The pathology of the deviated nose is discussed in relation to its bony and cartilaginous components. The importance of the interlocking stresses within the septal cartilage is pointed out especially with respect to continuing deformation after trauma. The methods of rhinometry are analysed and normal airflow through the nose is described. The effects on the nasal airway of a caudal dislocation of the septum, an angulation at the valve area, a high septal deflection and an excessively wide choana are discussed. In the treatment of a deviated bony segment the difficulties of medial and lateral osteotomies are described. The indications for a septoplasty are thought to be a dislocated caudal end, a tip deviation and an external lateral angulation. The submucous resection of the septum should be reserved for resolved haematoma and cartilage absorption. The importance of the patient's priorities in deciding what operation to do are pointed out. Finally the experimental work on the effect of cartilage and mucoperichondrium resection on nasal growth is reviewed. It is suggested that a child with a severe septal deflection and airway obstruction should be offered a septoplasty taking care not to damage the mucoperichondrium.

scholarly journals One Time New Surgical Correction for Severe Upper Eyelid Acquired Ptosis

2017 ◽  
Vol 54 (3) ◽  
pp. 502-504
Author(s):  
Gheorghe Noditi ◽  
Mihail Cojocaru ◽  
Dan Grigorescu ◽  
George Noditi
Keyword(s):  
Surgical Approach ◽  
Preoperative Evaluation ◽  
Operative Procedure ◽  
Surgical Correction ◽  
Self Control ◽  
Palpebral Fissure ◽  
Active Muscle ◽  
Upper Eyelid ◽  
Frontalis Muscle ◽  
Chronic Use

Palpebral ptosis is a condition caused by different congenital and acquired pathologies. Seeing difficulty due to the visual field obstruction, prefrontal headaches due to chronic use of the frontalis muscle in an attempt to lift the eyelids and cosmetic deformity are the main complaints of the patients. The surgical correction of the ptosis can be challenging. According to the preoperative evaluation, the most appropriate technique should be used to maximize the postoperator result. We describe a new surgical approach for severe upper eyelids acquired ptosis consisting in reanimation of both eyelids by using the neighboring active muscle. We considered the patient a good candidate for the new surgical approach we introduce as one time operative procedure. The result was a normal palpebral fissure for both eyes. The advantage of this approach consists in performing one time surgery followed by immediate postoperative mobilization of the upper eyelids which determine the recovery of the upper lids motility by further self-control.

scholarly journals Electrocardiographic Changes before and after Surgical Correction of Isolated pulmonic Stenosis

1975 ◽  
Vol 87 (5-6) ◽  
pp. 437-449
Author(s):  
Akiko Okuyama ◽  
Setsuro Tanetani ◽  
Nagayasu Ogasawara ◽  
Hiroshi Sakai ◽  
Hiroshi Sakakibara ◽  
...  
Keyword(s):  
Surgical Correction ◽  
Pulmonic Stenosis ◽  
Before And After ◽  
Electrocardiographic Changes

The nasal cavity and paranasal sinuses

2013 ◽  
Author(s):  
Martin E. Atkinson
Keyword(s):  
Nasal Cavity ◽  
Nasal Septum ◽  
Goblet Cells ◽  
Septal Cartilage ◽  
Olfactory Mucosa ◽  
Nasal Cartilages ◽  
Orbital Roof ◽  
External Nose ◽  
The Right ◽  
Lateral Walls

The nasal cavity is the entrance to the respiratory tract. Its functions are to clean, warm, and humidify air as it is inhaled. Respiratory mucosa covered by pseudostratified ciliated epithelium and goblet cells, as described in Chapter 5 and illustrated in Figure 5.2B, lines the majority of the nasal cavity. The cilia and mucus trap particles, thus cleaning the air; the mucus also humidifies the air and warming is achieved through heat exchange from blood in the very vascular mucosa. The efficiency of all these processes is increased by expanding the surface of the nasal cavity by folds of bone. The nasal cavity also houses the olfactory mucosa for the special sense of olfaction although the olfactory mucosa occupies a very small proportion of the surface of the nasal cavity. The nasal cavity extends from the nostrils on the lower aspect of the external nose to the two posterior nasal apertures between the medial pterygoid plates where it is in continuation with the nasopharynx. Bear in mind that in dried or model skulls, the nasal cavity is smaller from front to back and the anterior nasal apertures seem extremely large because the cartilaginous skeleton of the external nose is lost during preparation of dried skulls. As you can see in Figure 27.1 , the nasal cavity extends vertically from the cribriform plate of the ethmoid at about the level of the orbital roof above to the palate, separating it from the oral cavity below. Figure 27.1 also shows that the nasal cavity is relatively narrow from side to side, especially in its upper part between the two orbits and widens where it sits between the right and left sides of the upper jaw below the orbits. The nasal cavity is completely divided into right and left compartments by the nasal septum . From the anterior view seen in Figure 27.1 , you can see that the surface area of lateral walls of the nasal cavity are extended by the three folds of bone, the nasal conchae. The skeleton of the external nose shown in Figure 27.2 comprises the nasal bones, the upper and lower nasal cartilages, the septal cartilage, and the cartilaginous part of the nasal septum.

Complications of Polydioxanone Foil Use in Nasal Surgery: A Case Series

2018 ◽  
Vol 34 (03) ◽  
pp. 312-317 ◽  
Author(s):  
Andrew Frankel ◽  
Oren Friedman ◽  
Leo Wang
Keyword(s):  
Case Series ◽  
Septal Cartilage ◽  
Saddle Nose ◽  
Nasal Surgery ◽  
The Past ◽  
Saddle Nose Deformity ◽  
United States Food ◽  
States Food ◽  
Nose Deformity ◽  
Pds Foil

AbstractPolydioxanone (PDS) foil is widely recognized as a septal cartilage replacement during rhinoplasties and is thought to be completely resorbable and biodegradable. Since its United States Food and Drug Administration approval in 2010, PDS foil has drawn significant enthusiasm and many surgeons consider it an ideal implantable biomaterial as reflected in numerous studies highlighting its benefits. However, scant literature exists highlighting relevant complications of PDS plates that may potentially lead to cavalier overuse. This descriptive case series assesses the outcomes of PDS foil usage in three patients seen for septoplasty at two independent institutions over the past 5 years. Our results demonstrate that PDS plate usage can lead to septal cartilage loss and resultant saddle nose deformıty associated with prolonged postoperative edema and inflammation. To our knowledge, this is the largest case series of this reported phenomenon.

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