Percutaneous osteotomy in rhinoplasty.
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Biomedical subjects
Publications and source records attributed to T R Bull.
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Silastic (Dow-Corning) implants are used for augmentation rhinoplasty. Complications following their use usually occur within the first 24 months. We report a case in which the dorsal splint became displaced spontaneously five years after surgery.
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A 30-year-old female presented with a ten-year history of bilateral conductive deafness. A pre-operative diagnosis of otosclerosis was made but at tympanotomy, the stapes crura in each ear was found to be disconnected from the footplate, the ossicular chain being otherwise normal. A Teflon-wire prosthesis was used to join incus and footplate, with good results. In the absence of a history of trauma or sepsis this may be a late presentation of a congenital stapedial anomaly which has not previously been reported.
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Submucosal diathermy (SMD) is a common surgical procedure carried out to improve the nasal airway. A case is presented in which it was followed by profuse epistaxis which required transfusion of 28 units of blood, eight units of fresh frozen plasma (FFP) and four units of platelets within 14 days.
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Aspects of rhinoplasty aesthetics as applied to the common nasal deformities have been presented with some comments on present day ethical considerations of this surgery. Airway obstruction due to vestibular narrowing with some alternatives for management are discussed.
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