A new technique in rhinoplasty.
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The purpose is to assist the surgeon in the selection of modifications for nasal osteotomies. Details of the technique include: 1. Incision for osteotomy made perpendicular to the pyriform rim and modified incisions, intraoral or through the Weir incision. 2. Rasping of the lateral nasal vault prior to any osteotomies. 3. Removal of a modified beveled wedge of bone prior to the medial osteotomy, unroofing the bony dorsum to a higher level. 4. The medial osteotomy done prior to either the lateral or the intermediate osteotomy. The intermediate osteotomy is performed prior to the lateral. 5. "Complete" and "fading" medial osteotomies are utilized as indicated. 6. The lateral osteotomy may be relatively straight and low depending then on a transverse fracture or may be high and curved meeting the fading medial osteotomy. 7. A sub-periosteal tunnel with the osteotome guard external to the bone is preferred to a submucosal tunnel.
This report addresses cartilage graft fabrication for augmentation of the full length of the nasal dorsum. The author describes a mortise/tenon joint for synthesis of discontinuous pieces of autologous septal cartilage into a structurally sound graft. The functional geometry of that mortise/tenon joint is reviewed. Specific details of surgical technique are presented. Excellent results in 14 of 16 consecutive cases of nasal dorsal onlay grafting by this method are reviewed. Unfavorable results in two cases are analyzed. The advantages and disadvantages of the technique are discussed. The mortise/tenon joint is proposed as a method for fabrication of a large, strong dorsal onlay graft from separate pieces of septal cartilage.
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The author discusses the relationship of the nasal tip and its protrusion to the physical contours of the dorsum. This relationship can be positive or negative. He emphasizes the necessity of correcting the tip before any correction of the dorsum, believing that correction of the alar cartilages is the key that determines the amount of hump resection or of lowering of the nasal dorsum, demonstrating his concepts with appropriate case illustrations. The author's technique (1974) of forward projection of the lower nasal base with a transverse silicone implant for patients with a negative tip-dorsum relationship is described.
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Turbinectomy, in cases of inferior or middle turbinate hypertrophy, is one of the solutions for nasal breathing difficulties. For many decades, this procedure was controversial owing to the severe complications believed to occur after such an operation. Its performance was held to be within the responsibility of otolaryngologists. However, eventually most of these complications were found to be nonexistent, and the performance of turbinectomy became a simple surgical procedure. The turbinate hypertrophy, which often exists on the contralateral side of the deviated septum, blocks the correct reposition of the septum with the consequent nasal bone, and thus prevents the plastic surgeon from achieving a straight nose. Therefore, proper handling of both septal deviation and turbinate hypertrophy is an important aid for the plastic surgeon. This article is dealing with the various aspects of turbinate hypertrophy and its surgical handling.
Current anthropometric measurements establish the nasofrontal angle. However, it is unwise to establish the lines and equilibrium of volumes of the face within fixed geometrical parameters. Even the data given by various forms of rhinometers do no seem to be suitable since they do not take into account the inclination and curvature of the forehead. The authors thus prefer to study the individual to be treated within a program of harmonization of the three areas of the face, the upper, middle, and lower thirds. The results of treatment utilizing this concept are depicted.
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The author suggests a method to protect the skin of the nose from vascular impairment, bruising, necrosis, and other complications by interposing between the nasal skin and the overlying splint or cast a protective layer of a soft delicate material such as Telfa or Scrylin.
BACKGROUND: The aim of the present study was to determine possible changes in olfactory threshold after functional and esthetic nasal operations and to evaluate whether these changes were recognized by the patients. METHODS: The study included 41 patients before and after nasal surgery (septoplasty, septorhinoplasty). Nasal airway resistance, olfactory thresholds, and subjective symptom scores were evaluated and compared pre- and postoperatively. The mean follow-up was 5.4 months. Olfactory performance was assessed using the Sniffin' Sticks. RESULTS AND CONCLUSIONS: The postoperative values in the screening test for olfactory sensitivity were not significantly different from those before nasal surgery. Nasal ventilation was improved postoperatively in all patients, assessed by determination of nasal airway resistance and subjective symptom scores. Besides an increase in nasal ventilation, functional and esthetic nasal operations can lead to improvement of olfactory function. The rarely seen postoperative increase in olfactory threshold does not seem to be subjectively recognizable by the patients.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.