Primary aesthetic rhinoplasty

Rhinoplasty is the aesthetic surgical intervention that covers the reshaping of the external nasal pyramid. It includes aesthetic and functional aspects, and addresses developmental or acquired pathology. Characteristically, it is associated with significant psychological overlay and due to the complex three-dimensional nasal structure it is the object of intense patient scrutiny involving fine detail from multiple angles. Nasal physiology characteristics dictate that aesthetic alterations can have profound physiological effects that need to be considered carefully in the design and execution of rhinoplasty surgery.

Partial Maxillectomy for the Improvement of Nasal Obstruction Can Be Combined with Septorhinoplasty

We describe the (anteromedial) partial maxillectomy technique which can be used to address impaired nasal breathing in cases of significant protrusion of the frontal process of the maxilla into the nasal cavity, narrowing the nasal pathway. It fits to nasal physiology avoiding mucosal resection. It can be combined with surgery of the inferior turbinate. The described technique can be used in all forms of rhinoplasty.

Surgical management for inferior turbinate hypertrophy: a narrative review

<p class="abstract">Inferior turbinate hypertrophy can lead to bothersome symptoms of the nose. Inferior turbinate reduction has to be treated surgically for cases, which are refractory to medical treatment. Plethora of surgical techniques have evolved over the recent years to surgically treat inferior turbinate hypertrophy. Yet, there remains a lack of consensus on optimal surgical technique or a cumulative study on the merits and demerits of the surgical procedures performed. The aim of the study was to review 26 articles from time period of January 2000 to January 2021 studied on surgical techniques of turbinate reduction. On reviewing the studies, it was noted that conventional turbinectomy techniques were not preferred by surgeons to avoid chances of severe complications and hence more studies on newer advanced techniques were noted. Among the newer techniques to find an adequate balance between nasal physiology and tissue preservation RFTVR is preferred and is the optimal technique owing to its minimal invasion, performance ease and reduced complications. Most recent studies represent the benefits of RFTVR. </p>

Nasal Septal Perforation Repair with an Inferior Turbinate Flap and Acellular Dermal Matrix

Nasal septal perforation is an uncommon disorder that can cause disturbance of nasal physiology. The perforations can vary widely in size, location, and symptomatology. Many different closure techniques have been described in the literature; however, no gold standard has been recognized. The choice of surgical technique usually depends on the characteristics of the perforation and surgeon experience. Due to the goal of perforation repair being restoration of normal nasal physiology, techniques with the best outcomes have been those resurfacing the septum with nasal respiratory mucosa. Here we present our novel surgical method for large (> 2 cm) septal perforation closure using a modification of the inferior turbinate flap repair using a polydioxanone plate and the acellular dermal matrix allograft (Alloderm, Allergan Inc.).

Outcomes of mucociliary clearance and rhinomanometrical changes in nasal pathology

OBJECTIVE. The aim of the study was to determine the impact of the nasal pathologies over nasal mucociliary clearance and rhinomanometric parameters. MATERIAL AND METHODS. This is a retrospective analytical observational clinical study during a period of 6 months, between 2014 and 2015. 123 subjects, 63 of whom had nasal pathology and 60 of whom were healthy controls, were enrolled in this study. The diagnosis of nasal pathology was made based on clinical examination, nasal endoscopy and anterior rhinomanometry. A methylene blue test was used to evaluate the mucociliary clearance. RESULTS. The subjects with nasal pathology had nasal septum deviation (No=50), chronic rhinitis (No=42), rhinosinusitis (No=15) and nasal polyposis (No=17). The mean total air flow in inspiration in nasal pathology patients group was 546.7 ml/s (millilitre/second), with a median of 594 ml/s, comparing with the control group who had the mean air flow of 865.5 ml/s, with a median of 866.5 ml/s. In expiration, the mean air flow in those with nasal pathology was 603.9 ml/s and a median of 611 ml/s, comparing with the control group who had the mean air flow of 871.1 ml/s and a median around 872 ml/s. The mean time from the application of methylene blue liquid to first seeing it in patients with nasal pathology was 23.41 minutes for the right nostril and 23.32 minutes for the left nostril, comparing with the control group who had the mean of mucociliary clearance of 6.76 minutes for the right nostril and 6.93 minutes for the left one. CONCLUSION. The results obtained in anterior rhinomanometry and methylene blue liquid test showed that nasal pathology does affect nasal physiology and it is an important factor to evaluate the mucociliary clearance.