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At least 487 records · Page 27Linked to original sources
PubMed1998

Evaluation of the results of delayed rhinoplasty in cleft lip and palate patients. Functional and aesthetic implications and factors that affect successful nasal repair.

Patients born with cleft lip and palate (CLP) present with a variety of nasal deformities. These are either congenital or iatrogenic. Our aim was to establish a correlation between aesthetic and functional nasal impairments in patients with CLP whose nasal reconstruction had been delayed. Fifty-four randomly selected patients with CLP deformities, all of whom had delayed nasal repairs were evaluated objectively, aesthetically in three planes, and functionally for symptoms of nasal obstruction, chronic maxillary sinusitis, and olfactory disturbances. Aesthetically the patients were analysed from 1:1 life-size full face, profile, and submental-vertex photographs, and full skull cephalograms. Nasal patency was assessed by rhinomanometry. The presence of chronic maxillary sinusitis and olfactory disturbances were deduced from the history. The degree of nasal dismorphism correlated with the severity of nasal functional impairments. Delayed nasal repairs in patients with CLP did not produce satisfactory aesthetic or functional results, probably because growth was retarded and midfacial development was disturbed at the time of delayed rhinoplasty and resulted in asymmetry. In CLP the nose should be repaired during the early primary cheilorhinoplasty, as this is essential for the restoration of a normally functioning and aesthetically pleasing nose.

Adolescent↗
PubMed2002

[Rhinoplasty in the immediate assumption of responsibility of nasal burns. Technical note and report of two cases].

We report the use of a traditional technique of rhinoplasty in the immediate assumption of responsibility of deep burn of the nasal edge which cannot be grafted. The limit of the realization of this gesture lies in the fact that it must exist nasal morphological characteristics at the patient. The two cases presented had an hypertrophic nose with osseous and/or cartilaginous bump. The reduction height of the osseo-cartilaginous frame allows closing the defect without cutaneous tension. One carries out a true excision-joining of the burn of the nasal dorsum. We note at one year of retreat, the discretion of the scar located on the centre line of the nose, the absence of after-effects as well as the cosmetic satisfaction of the patients with respect to the modifications morphological their noses.

Adult↗
PubMed2002

The functional anatomy of the muscles of facial expression in humans with and without cleft lip and palate. A contribution to refine muscle reconstruction in primary cheilo- and rhinoplasties in patients with uni- and bilateral complete CLP.

The great variation of primary cheiloplasty procedures in Cleft Lip and Palate (CLP) patients shows that there is disagreement regarding the embryonic development of this part of the face, the macroscopic and microscopic functional anatomy of the human muscles of facial expression and their role as a functional matrix for balanced and harmonious facial development. The purpose of this study is to present results of microsurgically dissected facial muscles, several parts of the nose and the human midface in specimens with and without cleft lip and palate. The results are compared with those of other investigations. Recommendations are presented for a standardized dissection technique of the facial muscles of expression for different types of primary cheilo- and rhinoplasty techniques.

Cleft Lip↗
PubMed1995

The role of free pericranium grafts in augmentation rhinoplasty.

Various tissues and materials have been used in augmentation rhinoplasty. This paper presents a retrospective analysis of 14 patients, 8 female and 6 male, in whom free pericranium grafts were used in order to restore postsurgery or posttraumatic nasal defects. There were no complications from either the donor or the recipient site. The early and medium term results were satisfactory. It is concluded that free pericranium, compared with other autografts, is a good alternative due to its several advantages and hardly any disadvantages. In selected cases it can even be the material of choice.

Adolescent↗
PubMed1990

Primary unilateral cleft lip repair without primary rhinoplasty. A preliminary report.

A primary unilateral functional lip-plasty has been developed to improve the appearance of the asymmetrical nasal deformity and that of the lip scar in the cleft lip. A triangle is dissected from the lesser segment with the base located at the nasal alar base. The latter is rotated superior-horizontally and positioned at a semicurved release incision which is inferior to the columella. This C-junction of the nostril sill allows an alignment of the nasal structure without a primary rhinoplasty.

Cleft Lip↗
PubMed2002

Structure approach in rhinoplasty.

Many postoperative sequellae of rhinoplasty can be prevented by minimizing resection of the supporting tissues of the nose and by using structural grafting to increase tip support. Stabilizing the nasal base is a critical step in providing a good long-term outcome with preservation of nasal tip projection. The surgeon must also anticipate the effects of scar contracture, which can aid in creating a favorable tip contour over time and avoid complications.

Esthetics↗
PubMed1983

Rhinoplasty: aesthetics, ethics and airway.

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.

Airway Obstruction↗
PubMed1990

Chondroplastic graft augmentation rhinoplasty.

A challenging surgical problem is the correction of supra-tip depression of the nose following collapse of nasal septal support. Numerous materials have been used in augmentation rhinoplasties attempting to correct this deformity, all having certain disadvantages. A modified technique is described in which costal cartilage surrounded by perichondrium is grafted in such noses; the results of a small series is discussed. The problems of graft distortion and resorbtion appear to have been satisfactorily overcome by using this procedure.

Adolescent↗
PubMed2006

Rolled auricular cartilage grafts for dorsal augmentation rhinoplasty.

We present a technique, which has not been previously described in the literature, of using rolled autogenous conchal cartilage for dorsal augmentation via an endonasal or external rhinoplasty approach. This technique gives greater dorsal height compared with the more common layering techniques. It is most appropriate in the minimally or moderately saddled nose.

Ear Cartilage↗
PubMedDate not supplied

Open rhinoplasty: effectiveness of different tripplasty techniques to increase nasal tip projection.

PURPOSE: To study the effectiveness of 3 different tipplasty techniques to increase nasal tip projection (NTP). MATERIALS AND METHODS: NTP of 61 patients who underwent open rhinoplasty were retrospectively studied in 3 different tipplasty techniques used to increase NTP. Using a standard measurement technique, the preoperative and postoperative NTP ratio was measured for every patient preoperatively and at least 1 year after surgery. The study population of 61 patients was divided into 3 groups. Group 1 (n-32) underwent the author's routine nasal tip procedure (columellar strut, conservative cephalic trim of the lateral crura, and transdomal mattress sutures). Group 2 (n = 10) underwent the routine procedure and, in addition, has further medical recruitment of the lateral crura. Group 3 (n = 19) underwent the routine procedure and, in addition, has a tip cartilage graft. RESULTS AND CONCLUSION: The mean gain NTP postoperatively was highest in group 3 and lowest in group 1, and this was statistically significant. Causes of these differences in the NTP gain are discussed.

Adolescent↗
PubMed1997

Structural grafting in rhinoplasty.

The need for structural grafting in rhinoplasty arises when the nasal skeletal framework is weakened, malpositioned, or both. This review will be limited to structural grafting of the cartilaginous nasal skeleton. Current techniques will be reviewed and a technique introduced that addresses the common deformity of a superiorly rotated and deprojected nasal tip complex while simultaneously correcting nasal valve collapse. This technique is referred to as the Dynamic Adjustable Rotational Tip (DART) technique. The operative technique of the DART, as well as the basic philosophy regarding the tensile nature of the cartilaginous nasal skeleton will be described.

Ear Cartilage↗
PubMed1997

Implants in rhinoplasty.

A variety of materials have been employed in rhinoplasty for augmentation and reconstruction. While autogenous tissue remains the mainstay of nasal implants and are the clear choice for structural and augmentation grafting of the nasal tip, limited availability and unpredictable resorption or remodeling have made homologous and synthetic implants important considerations for dorsal augmentation grafting. This section discusses categories of graft materials, their physical properties, harvesting and preparation technique, and advantages and disadvantages. An algorithm for nasal implants for specific indications in support and augmentation is presented.

Biocompatible Materials↗
PubMed2002

The nasal base in cleft lip rhinoplasty.

The discussion on how to correct the nasal base in cleft lip (CL) rhinoplasty focuses on timing of the surgery, the type of approach, and the technique of repositioning the ala. Little attention is paid to the nasal vestibule. We compared the results of two different techniques. Forty-two patients were operated on via an endonasal approach with total mobilization of the lateral crus and fixation after repositioning. An external approach was used in 12 patients and the lateral crus freed as a medially based chondrocutaneous flap. The defect in the lateral vestibule wall was covered with an ear composite graft. The latter group showed more stable results concerning symmetry and breathing. We conclude that in most cases of unilateral CL noses there is not only a malposition and deformity of soft tissues and skin of the ala, but also a deficiency in the surface of inner lining of the nasal vestibule that needs appropriate repair. In general, the numerous procedures for repair of the nasal base in unilateral CL patients can be attributed to three principles based on different philosophies concerning the underlying pathology.

Adolescent↗
PubMed2002

Secondary rhinoplasty in the bilateral cleft.

Secondary rhinoplasty in bilateral clefts is very complex due to its specific pathological anatomical characteristics. In this article, the general and specific characteristics of the nose of the bilateral clefts are described and careful preoperative assessment is emphasized. We discuss the timing of the operation considering growth inhibition and psychological aspects and a systematic rational surgical approach, dividing the operative procedure into: septal surgery, tip surgery, osseocartilaginous vault surgery, maxillary augmentation, and alar base reallocation. We report results of a retrospective study to evaluate the postoperative care with a custom-made vestibulum device to prevent stenosis of the vestibulum caused by scar tissue retraction in the postoperative period.

Adolescent↗
PubMed2002

Anatomic considerations in aesthetic rhinoplasty.

A thorough understanding of nasal anatomy and physiology remains critical when approaching the nose to correct any contour or functional deficiencies. This article reviews the salient, anatomic features of the nose that are relevant to the rhinoplasty surgeon and further highlights basic surgical techniques that illustrate the anatomy germane to aesthetic surgery. The external anatomy of the nose is discussed in regard to the skin/ soft-tissue envelope, the superficial musculoaponeurtic system/muscular layer, the bony/ cartilaginous framework, and the dynamic tip-support mechanisms. The discussion of internal nasal anatomy concerns functional aspects of the nose, particularly the valvular components and the septum-turbinate complex.

Cartilage↗
PubMed2002

The Asian nose: augmentation rhinoplasty with L-shaped silicone implants.

Few procedures in facial plastic surgery elicit the controversy that surrounds augmentation of the Asian nose. Asian surgeons generally advocate augmentation with custom-fabricated silicone prostheses, a technique that Western surgeons, who strongly recommend autogenous material, condemn as inherently dangerous. Analysis of the evidence relating to augmentation with silicone prostheses suggests that there is little factual support for Western dogma and indicates that, when properly executed, augmentation with silicone implants yields reliable and consistently superior aesthetic results. A detailed blueprint for execution of augmentation rhinoplasty with custom- fabricated silicone implants is provided.

Asian People↗