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At least 217 records · Page 12Linked to original sources
PubMed2000

Retrospective review of augmentation rhinoplasties using autologous cartilage grafts.

The use of graft materials in rhinoplasty presents many challenges for the surgeon. There are a wide variety of alloplastic materials available for nasal augmentation but the graft material of choice remains autologous cartilage. It has considerable advantages over alloplasts. It does not induce an immune response and has a very much lower rate of infection or extrusion. It is also easily harvested and sculpted and is available in plentiful supply. We present a retrospective review of 103 patients who underwent augmentation rhinoplasty using autologous cartilage grafts with a mean follow-up time of three years six months. The revision rate over the follow-up period was 15.5 per cent (n = 16). The same surgeon's revision rate for rhinoplasty without graft over the same period was four per cent in 311 cases. We conclude that while autologous cartilage remains the best graft material available there is a significantly higher revision rate than when no graft is required. This is primarily due to the unpredictable scarring associated with the graft in the medium term and the asymmetric nature of conchal cartilage.

Adolescent↗
PubMed1976

Nasal obstruction after rhinoplasty: etiology, and techniques for correction.

Of 1,000 consecutive patients who underwent rhinoplasty, about 10 percent had some nasal obstruction postoperatively. The majority of patients in whom the author performed the primary rhinoplasty had an obstructive, vasomotor type of rhinitis that ensued, and which usually could be cured by the injection of corticosteroids into the turbinates. Fifty patients had undergone rhinoplasty by other surgeons, and most of those patients requested surgical correction to relieve the nasal appearance. In those patients the causes of nasal obstruction were; pre-existent, undetected, or diagnosed but uncorrected, septal deviation; or turbinate hypertrophy; intranasal adhesions; scar tissue web formation in the nasal vault; inadequate nasal tip support, and alar collapse. The author's technique of surgical repair for each of these conditions is outlined.

Airway Obstruction↗
PubMed1995

Reduction rhinoplasty and nasal patency: change in the cross-sectional area of the nose evaluated by acoustic rhinometry.

The feeling of nasal patency is related to the dimensions of the nasal cavity. After aesthetic reduction rhinoplasty, the cross-sectional areas of the nose may decrease critically. In this study, acoustic rhinometry, a new method based on acoustic reflections, was used to evaluate the internal dimensions of the nasal cavity in 37 patients before reduction rhinoplasty and again 6 months after surgery. The internal dimensions of the nasal cavity--especially the anterior dimensions--were reduced after rhinoplasty. Compared with the preoperative values, the minimum cross-sectional area (at the nasal valve) decreased by 22% (totally) to 25% (unilaterally) (P = .000), and the cross-sectional areas at the piriform aperture decreased by 11% to 13% (P = .02).

Acoustics↗
PubMed2003

Rhinoplasty.

Rhinoplasty--surgery to reshape the nose--is a common procedure for both cosmetic and functional requests. In this article, the author provides an overview of rhinoplasty, with special emphasis on the surgical anatomy and preoperative analysis of appearance. A review of some of the surgical techniques at the disposal of the rhinoplasty surgeon is also provided and illustrated with patient examples.

Adult↗
PubMed2005

The role of powered instrumentation in rhinoplasty and septoplasty.

Rhinoplasty and septoplasty are commonly performed surgical procedures that have as many variables in execution as the number of surgeons that perform them. Initially, these procedures were performed using manual instrumentation. Recently, however, powered instruments have been used to perform portions of the two procedures. Powered oscillating rasps have been described for reducing dorsal bony humps during rhinoplasty, and it has been suggested that powered osteotomes may reduce tissue trauma when performing nasal osteotomies. Powered burrs have also been used for taking down dorsal bony humps and refining boney irregularities. Although septal spurs have traditionally been excised manually, powered instrumentation has proved useful in this area as well. This article reviews the indications for using powered instrumentation in rhinoplasty and septoplasty.

Humans↗
PubMedDate not supplied

A multicenter evaluation of the safety of Gore-Tex as an implant in Asian rhinoplasty.

BACKGROUND: A retrospective multicenter study examined the safety of Gore-Tex as a nasal implant in rhinoplasty. METHODS: This study involved 853 patients (656 primary surgeries and 197 secondary surgeries) who had undergone rhinoplasty and used Gore-Tex either at the dorsum or at the nasal tip. Data were extracted from the medical records by surgeons and entered on a standard form. Data included the information about the demographics and history of the patient, method and results of surgery, complications, follow-up, and various factors believed to predispose to complications. RESULTS: The average follow-up period was 18 months. Overall complication rate associated with Gore-Tex was 2.5% (21 cases). Infection was the most common complication (18 cases; 2.1%) followed by two cases of seroma and one case of persistent nasal swelling. Among the 21 suffering complications, 19 patients (91%) needed graft removal. Nine cases of infection developed in primary surgeries (1.4%) and nine cases developed in secondary surgeries (4.6%), which represented a statistically higher complication rate in those undergoing secondary surgery (p = 0.0062). Infections developed within 1 month in five cases and nine cases developed infection >6 months postoperatively. Other complications including esthetic problems were identified in 16 cases (1.9%). CONCLUSION: Gore-Tex should be used judiciously in rhinoplasty because of a 2.1% infection rate, a risk that is higher still after secondary surgery; moreover, once infected, Gore-Tex implants usually require removal.

Adult↗
PubMed1986

Routine reinsertion of the hump in rhinoplasty.

Reinsertion of the hump as a free graft, a technique based on the rhinoplasty described by Skoog, has been performed for more than 10 years in severely deviated noses to hide residual deformities of the septum after rhinoplasty. The results have been so encouraging that this technique is now routinely used in all rhinoplasties requiring a reduction of the profile. Grafting the hump after remodelling gives a natural aspect to the dorsum, especially in patients with thin skin where irregularities of sharp edges of the cut nasal bones are otherwise often seen. The hump is tailored into a thin composite graft (bone + cartilage) 3-4 cm long and 3-5 mm broad. No major complications have been observed. 32 cases have been reviewed after a mean delay of 24 months. 29 show radiographic evidence of bone graft survival although no fusion with the nasal bones is observed. It is suggested that facial bone grafts survive better in the nose than grafts taken from the iliac crest or the ribs.

Humans↗
PubMed1997

[Augmentation rhinoplasty with particulate hydroxy apatite artificial bone in 50 cases--a follow-up of 8 years].

To investigate the long term results of the particulate hydroxy apatite (HA) artificial bone in augmentation rhinoplasty, 50 patients were followed up for 8 years after the operation. The clinical study included the patient's self-evaluation and the surgeons' objective evaluation of the operation results, analysis of nasal radiographs for the position, shape of the HA implant and its relation with the nasal bone. The observations show that HA is stable and the long-term results of augmentation rhinoplasty with HA are very good. It is concluded that HA is a new, ideal, bioactive filling material for augmentation rhinoplasty.

Adult↗
PubMed1999

Endoscopic-powered rhinoplasty.

OBJECTIVE: To present a new method for sculpting the bony nasal dorsum in rhinoplasty surgery. MATERIALS AND METHODS: Fifteen patients underwent powered dissection of the nasal dorsum during cosmetic and reconstructive rhinoplasty. The precise technique is described and its benefits are discussed. RESULTS: All patients had acceptable postoperative results using this technique. Intraoperative bleeding and postoperative ecchymosis appeared to be reduced. No complications were noted. CONCLUSIONS: Endoscopic-powered rhinoplasty provides an excellent approach to the bony dorsum. It allows sculpting to be completed under direct vision, permitting precise contouring and easy visualization by associates. It can be completed easily and safely with standard microdebrider equipment. Its use should be considered in situations requiring precise contouring of the bony nasal dorsum.

Endoscopy↗
PubMed1998

[A study of photographic standardization in rhinoplasty].

OBJECTIVE: A method of photographic standardization for rhinoplasty is presented. METHOD: To delineate the nose objectively before and after rhinoplasty, we designed a method to standardize picturing by using the points and lines in the face and camera in nasal photography. RESULT: With the help of anatomic points in the face and lines in the camera, we can maintain the camera at a constant position to the face. In this way, the nasal picture is more comparable and instructive. CONCLUSION: This method has been proved to be helpful in rhinoplasty.

Female↗
PubMed2000

Refractory facial cellulitis following cosmetic rhinoplasty after cord-blood stem cell transplantation.

We report a case of a 38-year-old female patient who developed facial cellulitis after cord-blood stem cell transplantation (CBT). The cellulitis was refractory to treatment with antibiotics and antifungal agents. Because facial cellulitis is rare after transplantation, its mechanism could not be determined exactly. On day 40 after CBT, a nurse with expertise in cosmetic surgery attended our rounds and correctly assumed that the patient had received cosmetic rhinoplasty. Although conventional x-rays of the head were normal, a computed tomographic (CT) scan of the brain disclosed the presence of a foreign body over the nasal dorsum. As a result, the patient's symptoms were diagnosed as facial cellulitis associated with foreign material that had been implanted at the time of cosmetic surgery. At a pretransplantation interview, the patient did not mention her history of rhinoplasty. Even after she was shown the head CT scans that revealed the presence of nasal implants, she denied that she had received rhinoplasty before CBT. Unless we realize that patients may have received cosmetic surgery before transplantation, it is difficult to make a diagnosis of infection associated with foreign implants. To our knowledge this is the first report after transplantation of infection associated with cosmetic surgery. Such infections should be included on the list of complications after bone marrow transplantation.

Adult↗
PubMed2001

Subconjunctival ecchymosis due to rhinoplasty.

Orbital complications of rhinoplasty show a wide range from minor complications like periorbital edema and ecchymosis to severe complications like blindness. Also, subconjunctival ecchymosis is one of the orbital complications due to rhinoplasty. A prospective study was set out to assess the incidence and progression of subconjunctival ecchymosis and to find out mechanisms of this complication. The incidence of subconjunctival ecchymosis was found to be 19.1%. Typically it appeared unilaterally or bilaterally over the temporal subconjunctival area in the first two days after the operation. Complete resolution of subconjunctival ecchymosis took approximately 11 +/- 3 days. No other ocular symptoms were found. Subconjunctival ecchymosis only prolonged the recovery period of the patient from the rhinoplasty.

Conjunctival Diseases↗
PubMed1975

Postoperative care of the rhinoplasty patient.

Postoperative care for the patient following rhinoplasty begins with the taping, packing, and splinting of the nose. In the immediate postoperative period the patient is encouraged to rest with the head in an elevated position, to take fluids by moutn, and to apply ice water compresses to the eyes. An analgesic sufficiently potent to ablate the pain as well as an evening sedative is prescribed, if needed. The systemic administration of enzymes, antibiotics, and steroids is not utilized by the authors in the postoperative care of rhinoplasty patients. Careful attention to maintaining the position of the nasal dorsum and the removal of any hematoma is essential in the first two postoperative weeks. During the first year following rhinoplasty, participation in contact sports and exposure to the sun are discouraged.

Bandages↗
PubMedDate not supplied

[Results of open structure rhinoplasty].

OBJECTIVES: This study aimed to evaluate the techniques used in open structure rhinoplasty operations, together with a presentation of our results and experience. PATIENTS AND METHODS: The study included 122 patients (64 males, 58 females; mean age 27 years; range 17 to 48 years) who underwent open structure rhinoplasty. Of these, 72.9% had primary, 9% had revision surgeries; 18% had traumatic deformities. The mean follow-up period was 18 months (range 3 to 24 months). RESULTS: We did not encounter transcolumellar scar formation or flap necrosis in any of the cases. In five cases (4%), edema and hyperemia were detected in the columellar skin in the early postoperative period. Resorption of the tip graft developed in one (0.8%) of the patients in whom auricular cartilage grafts were used. A year after surgery, one patient (0.8%) presented with granulation tissue formation in the nasal vestibule, secondary to the use of nylon suture material. Axial deviation was seen in the early postoperative period in two patients (1.6%). Five patients (4%) required revision surgery. CONCLUSION: Open structure rhinoplasty gives excellent results when employed on proper indications and by experienced surgeons.

Adolescent↗
PubMed1957

Cosmetic rhinoplasty.

Rhinoplasty is safe, relatively painless and, if patients are carefully selected, quite successful. Psychological and personal benefits amply justify the procedure. Frequent indications are feelings of social rejection or ridicule and racial discrimination. Psychoneurotic patients with severe complexes, however, are poor subjects for rhinoplasty and should not be operated upon. It is doubtful that rhinoplasty grossly changes the physiologic integrity of the nose. Psychological trauma to the patient during hospitalization is to be avoided, sedation properly gauged for each patient, and complete block anesthesia used to preserve the cough reflex. The operation is brief and a small splint is worn for a few days. Complications are rare.

Humans↗
PubMed2004

Nose: aesthetics and function. Rhinoplasty and functional problems related to anterior ethmoid.

Aesthetic nasal surgery has progressed in the last years, as concerning both surgical techniques and surgical instruments, which allowed the finding of new and more sophisticated surgical solutions. Clinical practice led to observe sometimes functional surgical failures, due rather than an inaccurate surgical technique, to an incomplete diagnostic approach to the patient. It has been observed that modifying the external conformation of nasal pyramidis inner-nose volumes and spaces will be subsequently reduced, giving as a result a condition which is only aesthetically but not functionally valid. 32 subjects, selected for a rhinoplasty and presenting nasal respiratory obstruction and anterior ethmoid abnormalities, confirmed by nasal endoscopy and nasal CT, were evaluated and subdivided into two groups: the first (A) group underwent only to an aesthetic rhinoplasty, the second group (B) was operated of a rhinoplasty combined with functional endoscopic sinus surgery (FESS) in order to correct the above mentioned anatomical abnormalities. The nasal airflow, and though the nasal cavities patency, was evaluated pre- and post-operatively in the two groups of patients, referring to rhinomanometric conductance values. Patients of group A reported decreased post-operative conductance values, patients of group B reported increased post-operative conductance values, showing though the functional involvement of anterior ethmoid in nasal obstruction and the necessity of correcting its anatomical abnormalities, in order to reach not only a new nasal profile, but also a better respiratory performance.

Adolescent↗
PubMed2005

[Nostril retainers in the primary cleft rhinoplasty].

INTRODUCTION: The nasal cleft cartilage tends to depression after primary rhinoplasty. Nasal stents are probe to be useful in the management of these patients in order to maintain the new morphology. AIM: The purpose of this paper is to present our experience with the use of postoperative nasal splinting in the management of cleft lip nasal deformity. PATIENTS AND METHODS: A nostril retainer was placed in 18 cleft patients (4 bilateral, 14 unilateral) during primary repair of the cleft lip nasal deformity from 2001 to 2004. The nasal morphology in the postoperative period was compared with that of 10 control patients who were operated on without nasal stenting in a previous period. Nostril retainers were left in place after the rhinoplasty using 4/0 poliglecaprone absorbable. Those sutures fixed the stent in place during three weeks after surgery. Results. Average follow-up was 18.5 months. Retention of the splint was 3.5 months mean time (range 4 weeks to 6 months). The methods employed for retention were multiple based upon parental preferences. Photogrammetric analysis showed relevant asymmetry of the nostrils in 10% of the splinted group as compared with 48% for controls (p<0.001). CONCLUSIONS: The use of nasal stents has been found effective postoperatively after cleft primary rhinoplasty, avoiding relapse of the nasal reconstruction and drop of the nasal ala. Retainers also allows airway patent and avoid surgical adhesions due to nasal secretions and scarring. Parental collaboration is needed.

Abnormalities, Multiple↗
PubMed1991

[Esthetic rhinoplasty in the elderly].

The classical refusal to perform rhinoplasty in elderly subjects needs to be revised. In fact, this operation gives satisfactory results provided the patients are well selected on the basis of psychological and anatomical criteria. Apart from the repair of accidental or surgical skin defects, the delayed request from rhinoplasty candidates should be carefully assessed and, when in doubt, the patient may require psychiatric consultation. The major technical problem is that of the lack of elasticity of the skin requiring very moderate modifications of the osteocartilaginous skeleton in every case and occasionally skin resections to allow skin cover of the revised structures. Various techniques for the root of the nose have been proposed. The classical difficulty for elderly people to assume their new body image is more theoretical than real provided "minimal" rhinoplasties are performed. This operation warrants a place in the surgery of ageing.

Aged↗