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PubMed1986

The relationship of lateral osteotomies in rhinoplasty to the lacrimal drainage system.

Damage to the lacrimal drainage system is a potentially complicating factor in rhinoplasty utilizing lateral osteotomies. The authors present data from osteotomies performed on a series of fresh cadavers. Following completion of the osteotomies, the lacrimal sac and nasal lacrimal ducts were identified and cannulated. Soft tissue was dissected to demonstrate the osteotomy site. The specimen was inspected to delineate involvement (if any) of the lacrimal duct or sac. The proximity of the osteotomy site to the lacrimal drainage apparatus components was measured in each specimen. Various parameters were observed, including the effect of curved vs. straight osteotomies, guarded vs. unguarded osteotomies, and the effect of various widths of osteotomies. Likewise, the degree of risk to the lacrimal system was evaluated, and the technique of the novice and resident surgeon was compared to that of the experienced rhinoplastic surgeon. A low, curved osteotomy, performed with a sharp osteotome without subperiosteal tunnels, provides the safest maneuver. Lateral osteotomies, properly performed, prove to be an unusual cause of lacrimal drainage dysfunction.

Cadaver↗
PubMed1994

Transsphenoidal hypophysectomy through the external rhinoplasty approach.

The external rhinoplasty approach is a refinement of the well-recognized sublabial transseptal technique for transsphenoidal hypophysectomy first introduced by Cushing in 1910. This article relates our experience with 111 cases of transsphenoidal hypophysectomy performed during a 10-year period (1982-1992) and includes a detailed description of our use of the external technique. Fifty-one patients were male, and 60 were female. Ages ranged from 12 years to 80 years, with an average of 46 years. One hundred one patients had pituitary adenomas, four had craniopharyngiomas, two had inverting papillomas, and there was one each of lymphoma, metastatic prostate cancer, pituitary abscess, and posttraumatic cerebrospinal fluid leak. Nine of the operations were for recurrent adenomas. Complications included 8 symptomatic anterior septal perforations and 13 asymptomatic posterior perforations. Five had transient cerebrospinal fluid rhinorrhea, five had perioperative hemorrhages, two had minor postoperative columellar deformities, and one had injury to the internal carotid artery requiring embolization. We have found the external technique for transsphenoidal hypophysectomy to be a reliable and facile means for nasal exposure of the sphenoid sinus and pituitary gland without loss of nasal tip projection or significant cosmetic deformity.

Adenoma↗
PubMed2000

Rhinoplasty in unilateral cleft lip nasal deformity.

An operation is described for correction of unilateral cleft lip nasal deformity which has had considerable uniformity of success and is applicable to both mild and severe degrees of deformity. Our proposed repair technique is performed through an external rhinoplasty approach and depends on repositioning of the displaced and deformed cartilages together with the reinforcement of the structural support of the nose by using multiple cartilage grafts. This surgical technique was used in 18 consecutive adult patients with unilateral cleft lip nasal deformity and yielded consistently good long-term functional and cosmetic results.

Adolescent↗
PubMed1977

"Practical suggestions on facila plastic surgery--how I do it". External marking in rhinoplasty planning.

Photographs, drawings, and examination at consultation have value in rhiniplastic planning. However, the surgeon is not operating on photographs, drawings, or an alert sitting or standing patient; he is operating on a nose with what was forward now facing upward. We find it most helpful to plan and mark almost the entire procedure on the external nose and surrounding structures just before the patient is put supine and sedated or anesthetized. In primary rhinoplasty, it is possible to mark essentially all skeletal anatomy within 1 mm tolerances by palpation, pushing the tip up and back, observing the changes from the outside, and looking at the inside. We believe that the anatomy and planned changes can and should be depicted by appropriate marks put on the skin. There mere act of drawing in the procedure forces us to think it through from beginning to end, a most worthwhile endeavor. Moreover, we learned very shortly after we began forcing ourselves to quantitate the anatomy and proposed changes, that we ran into fewer and fewer surprises as we worked. Photographs taken of the markings become by far the best "operative note" we can have. Comparison of these with the patient or his photographs showing the result allow us to make accurate judgments about long term effects of each surgical maneuver. Much that seemed mysterious before is found to be quite scientifically explainable. We do not propose in this short report to show how we mark every nose. Rather we shall show with drawings and a few examples how we go about marking a nose. The reader may use the suggested marking techniques or may evolve his own. The important thing is that he work out a system meaningful to him. It will be noted that we have used differing techniques for depicting similar concepts from case to case. In other words, we have not settled immutably on one system because we are still searching for the best.

Female↗
PubMed1986

The nasal bossa: a complication of rhinoplasty.

A study of 1,033 consecutive rhinoplasties was undertaken to focus on etiology and treatment of nasal bossa. Of the 2% that developed bossa, the only consistent, statistically significant etiology factor was that of preoperative nasal asymmetry. There was no correlation with skin or cartilage characteristics. Those tips requiring alteration by the delivery technique were five times more likely to develop bossa than those treated by cartilage split or retrograde techniques. The surgical dilemma of treatment by either augmentation of the lesser side or resection of the bossa was discussed.

Adult↗
PubMed1987

Steps for a safer method of osteotomies in rhinoplasty.

Knowledge of osteotomy technique is essential to rhinoplasty. Using cadaver specimens, in addition to clinical observation, a safer method of osteotomy was acquired. Discussion of anatomy with reference to medial and lateral osteotomy follows. Several safety tips for each type of osteotomy are given.

Humans↗
PubMed2005

Aesthetic and functional rhinoplasty.

The authors stress that conservative correction should be the main goal in aesthetic and functional rhinoplasty. The surgeon controls the operative event and must be skilled at manipulating and controlling the dynamics of postoperative healing to achieve long-term functional and aesthetic results.

Adult↗
PubMed1976

Corticosteroid therapy in rhinoplasty.

3 years experience in corticoid treatment of more than 796 cases of rhinoplasty is reported. A remarkable reduction of oedema after surgery was observed. The application of 40 mg Corticoid crystalline suspension on each side of the nose following surgical procedure is recommended.

Edema↗
PubMed1999

The role of open rhinoplasty in the management of nasal dermoid cysts.

The nasal dermal sinus cyst is one of many midline nasal masses that often pose diagnostic and treatment dilemmas for the plastic and reconstructive surgeon. The differential diagnosis of the midline nasal mass includes both congenital and acquired processes. A thorough understanding of its cause is crucial to treatment. A comprehensive discussion of the pathogenesis, diagnosis, sequelae, and surgical management, and a representative case analysis, of the nasal dermal sinus cyst is presented to delineate the role of open rhinoplasty in optimizing the care of this congenital nasal deformity.

Adolescent↗
PubMed1998

Rhinoplasty in achieving total facial harmony.

Surgical alteration of the nose has challenged surgeons for decades and rhinoplasty is often described as one of the most difficult aesthetic procedures to master. As in the case of planning the orthognathic patient, there is a blend of aesthetic and functional goals. While patients may primarily present for cosmetic reasons, the maintenance of functional nasal airways in the pursuit of an improvement in facial balance is essential. It is the purpose of this paper to present the assessment and management of common nasal deformities, some of which are integrated within simultaneous orthognathic surgery.

Esthetics↗
PubMed1975

Large Indian forehead rhinoplasty. Case report.

The classic Indian rhinoplasty, with a midline forehead flap, was performed on 4 young adult patients with "cut noses". The rather large flaps survived in all cases, without a delay procedure, and the results were surprisingly good. The appearance of the donor area is, however, a problem-especially in patients with pigmented skins. The method is relatively simple and we believe it to be of value in selected cases.

Adult↗
PubMed1999

The role of open rhinoplasty in the management of nasal dermoid cysts.

The nasal dermal sinus cyst is one of many midline nasal masses that often pose diagnostic and treatment dilemmas for the plastic and reconstructive surgeon. The differential diagnosis of the midline nasal mass includes both congenital and acquired processes. A thorough understanding of its cause is crucial to treatment. A comprehensive discussion of the pathogenesis, diagnosis, sequelae, and surgical management, and a representative case analysis, of the nasal dermal sinus cyst is presented to delineate the role of open rhinoplasty in optimizing the care of this congenital nasal deformity.

Adolescent↗
PubMed1999

[The Vianeo and Gaspare Tagliacozzi. The development of rhinoplasty in the XVth century].

This article offers a short review of the history of the Rhinoplasty in Occident from A. Cornelius Celsus to the achievement of this surgical art in the XIXth century, with particular attention to the relations between the empiric practice of the Vianeo's medical-surgeons in Calabria and the academic medicine and surgery of Gaspare Tagliacozzi. In the Museum of History of Medicine of the University of Rome "La Sapienza" reproductions of surgical instruments described by G. Tagliacozzi in the "Curtorum Chirurgia..." are kept.

History, 16th Century↗
PubMed2001

[Corrective rhinoplasty in a patient with cleft lip nose deformity].

The author presents a case of secondary rhinoplasty in patient with cleft lip nose deformity. The preoperative computer planning and the stages of the surgery were observed. Good functional and cosmetic postoperative results were achieved by means of bone-cartilage autograft--a fragment taken from nasal dorsum and implanted in the nasal tip region. There is almost complete concurrence between the preoperative computer modeling and the good postoperative results.

Bulgaria↗
PubMedDate not supplied

[Resection of the depressor muscle of the tip in esthetic rhinoplasties].

Musculus depressor septi nasi is a muscle of facial expression, supplied by the facial nerve, it is more or less visible according to the individual. Easily exposed, using the intersepto-columellar incision, it is dissected from the skin surrounding it, then resected and in cases where the muscle is clearly defined, he can be brought up immediately. We consider resection of the musculus depressor septi nasi to be invaluable in rhinoplasty: -- firstly, to keep the tip of the nose well positioned during; -- secondly, to prevent certain "pseudo crow's-bill" deformities; -- finally, to give an impression of length to certain short upper (white ?) lips.

Female↗