scholarly journals Lateral intercrural suture in the caucasian nose: Decreased domal divergence angle in endonasal rhinoplasty without delivery

2012 ◽  
Vol 16 (02) ◽  
pp. 232-235
Author(s):  
Marcos Mocelin ◽  
Caio Soares ◽  
Rogério Pasinato ◽  
Andreia Frota ◽  
Cezar Berger
Keyword(s):  
Prospective Study ◽  
Divergence Angle ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Lateral Crus ◽  
Basic Technique ◽  
Nasal Tip ◽  
Definition Of

Summary Introduction: Several techniques can be performed to improve nasal tip definition such as cartilage resection, tip grafts, or sutures. Objctive: To evaluate the outcome of lateral intercrural suture at the lower lateral cartilage by endonasal rhinoplasty with a basic technique without delivery in decreasing the angle of domal divergence and improving the nasal tip definition. Method: This prospective study was performed in 64 patients in which a suture was made on the board head of the lower lateral cartilage in the joint between the dome and lateral crus, using polydioxanone (PDS) with sharp, curved needle. Results: In all of the cases, better definition of the nasal tip was achieved by intercrural suturing for at least 6 months postoperatively. Conclusion: Lateral intercrural suture of the lower lateral cartilage provides improved nasal tip definition and can be performed by endonasal rhinoplasty without delivery in the Caucasian nose.

The Isis Cruraplasty

1998 ◽  
Vol 15 (2) ◽  
pp. 137-141
Author(s):  
Steven Burres
Keyword(s):  
Surface Area ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Lateral Crus ◽  
Nasal Tip ◽  
Natural Configuration ◽  
Lateral Segment ◽  
Columellar Strut ◽  
Bulbous Nasal Tip ◽  
Tip Formation

Most of the reshaping techniques for a blunt, bulbous nasal tip reduce the curvature and surface area of tip lobule cartilage, and they reform the tip to add definition. Unfortunately, the assemblage of surgical maneuvers frequently reduces valued projection, and it may result in an unnatural tip formation with a distasteful pattern of contracture. Employing the Isis cruraplasty allows incremental tip enhancement and narrowing, while restoring or preserving the natural configuration. After lateral dome division and undermining of the medial portion of the lateral crus, the lateral segment of the lateral crus was transected incrementally and advanced to reenforce the deficiency in rim support. Sewing the medial flanges together created a cartilaginous platform that supported the Isis graft, and/or it accommodated a columellar strut, if indicated. The Isis cruraplasty conserves virtually all of the lower lateral cartilage without compromising the potential for tip reshaping and augmentation.

scholarly journals Research on Macroanatomic and Histologic Characteristics of the Lower Lateral Nasal Cartilages in Vietnamese

2019 ◽  
Vol 7 (24) ◽  
pp. 4224-4229
Author(s):  
Tran Dang Khoa ◽  
Ho Nguyen Anh Tuan ◽  
Nguyen Duy Bac ◽  
Nguyen Thanh Van ◽  
Pham Dang Dieu ◽  
...  
Keyword(s):  
Average Length ◽  
Descriptive Study ◽  
Lateral Cartilage ◽  
Average Thickness ◽  
Lower Lateral Cartilage ◽  
Fat Pad ◽  
Lateral Crus ◽  
Nasal Tip ◽  
Nasal Cartilages ◽  
The Right

BACKGROUND: There are recently many studies about the anatomy of lower lateral cartilage (LLC). However, the microanatomic studies to identify the segments of most LLC at the nasal tip in Vietnamese are very rare. AIM: Investigate the macroanatomic and microanatomic characteristics of the LLC and the structures of the nasal tip. METHODS: Descriptive study, 30 cadaver noses fixed by 10% formalin, 2 cadaver noses fixed by HE in 69 Institutes in Vietnam from December 2017 to April 2019. RESULTS: The average length of the medial crus is 12.3 mm on the right and 13.2 mm on the left. The maximum intercrural distance is 10.7 mm. The average length of the dome is 3.7 mm and 3.9 mm on the right and left side separately, with 2 subunits are the domal and lobular segment. The average thickness of the tip points is 1.0 mm. The width of the interdomal and intercrural ligaments are 0.5-fold the height and 2-fold the thickness. The thickness of the interdomal fat pad is 3mm and about 0.5-fold the wide. CONCLUSION: The LLC has 3 parts: intermediate, medial and lateral crus. The microanatomic structures of tip consist of the interdomal ligaments, intercrural ligaments, SMAS and interdomal fat pad.

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.

scholarly journals Cephalic lateral crural advancement flap

2021 ◽  
Vol 48 (2) ◽  
pp. 158-164
Author(s):  
Fuat Bulut
Keyword(s):  
Analogue Scale ◽  
Advancement Flap ◽  
Open Rhinoplasty ◽  
Nasal Patency ◽  
Lower Lateral Cartilage ◽  
Lateral Crus ◽  
Tip Rotation ◽  
Nasal Tip ◽  
The Mean

Background In lower lateral cartilage (LLC) surgery, cephalic trimming poses risks for the collapse of the internal and external nasal valves, pinched nose, and drooping deformity. The cephalic lateral crural advancement (CLCA) technique presented herein was aimed at using a flap to increase nasal tip rotation and support the lateral crus, in addition to the internal and external nasal valves, by avoiding grafts without performing excision.<br/>Methods This study included 32 patients (18 female and 14 male) and the follow-up period for patients having undergone primer open rhinoplasty was 12 months. The LLC was elevated from the vestibular skin using the CLCA flap. A cephalic incision was performed without cephalic trimming. Two independent flaps were formed while preserving the scroll ligament complex. The CLCA flap was advanced onto the lower lateral crus while leaving the scroll area intact. The obtained data were analyzed retrospectively.<br/>Results The mean age of the patients was 31.6 years (range, 20–51 years). The Rhinoplasty Outcome Examination scores after 12 months varied from 90 to100 points, and 93% of patients reported perfect satisfaction. At a 1-year follow-up, the patients’ nasal patency (visual analogue scale) rose from 4.56±1.53 (out of 10) to 9.0±0.65 (P<0.001).<br/>Conclusions The CLCA flap led to better nasal tip definition by protecting the scroll area, increasing tip rotation, and supporting the internal and external nasal valves without cephalic excision.

The Nasal Hinge

1994 ◽  
Vol 111 (3P1) ◽  
pp. 219-231 ◽  
Author(s):  
Peter A. Adamson ◽  
Todd A. Morrow
Keyword(s):  
Clinical Results ◽  
Plastic Surgeon ◽  
Hinge Region ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Lateral Aspect ◽  
Nasal Tip ◽  
Tip Projection ◽  
Facial Plastic

It is generally agreed that rhinoplasty is the most challenging procedure performed by the facial plastic surgeon. Mastery of nasal tip maneuvers to alter tip projection, rotation, and lobule refinement is intrinsic to successful rhinoplasty technique. The nasal hinge region comprises the most lateral aspect of the lower lateral cartilage. Its importance is often overlooked. As the foundation of the nasal base, It plays a key role in tip dynamics and can be sculpted to significantly modify projection, rotation, and lobule refinement. One hundred randomly selected rhinoplasty patients were studied with respect to the indications for hinge maneuvers, techniques applied, and resulting affect on tip aesthetics. Clinical results are shown. The applicability of these hinge techniques is compared with other lateral crural techniques. The importance of the hinge region in rhinoplasty dynamics and the necessity of knowledgeably applying surgical maneuvers in this region are discussed.

Median Horizontal Split Tip

1985 ◽  
Vol 93 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Frank M. Kamer ◽  
Alfred Cohen
Keyword(s):  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Horizontal Strip ◽  
Tip Rotation ◽  
Nasal Tip ◽  
Tip Projection ◽  
Innovative Technique ◽  
Central Strip ◽  
Nasal Tip Projection

One of the most difficult problems encountered in rhinoplasty is lack of nasal tip projection. An innovative technique is described that utilizes the removal of a median horizontal strip of lower lateral cartilage to enhance projection, while maintaining a natural highlight and tip support without the use of grafts. The indications are limited to noses that have a widened dome requiring removal of a central strip, and tip rotation. Alternate techniques are discussed; cases and results are discussed.

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).

Sign in / Sign up

Export Citation Format

Share Document