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The instruments for and problems of hump removal are discussed. The author describes his technique of lateral and medial osteotomies and stresses the importance of double or triple osteotomies with a special chisel.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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We present a case of nasal deformity due to sarcoidosis. The surgical management is discussed. The risk of secondary involvement of implanted autologous cartilage by the disease is emphasized. For this reason an inert allograft (silastic) is recommended for augmentation in this group of patients.
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The Glasgow Benefit Inventory, a validated post-interventional questionnaire, was used to determine patient benefit from septorhinoplasty according to indication (function, cosmesis or a combination) in 87 patients. We showed a very significant patient benefit from this procedure and have demonstrated that the benefit is greatest when cosmesis is an indication (P = 0.05).
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Accurate placement of intranasal incisions to achieve external alar symmetry is difficult. A detailed anatomical knowledge of intranasal anatomy is required to allow an appropriate incision to be made within the nasal vestibule. By marking the level of the intracartilaginous incision on the external surface using a pair of alice forceps, the marking is subsequently transferred onto the vestibular nasal surface. The initial incision can therefore be made on the vestibular nasal surface along the marking made by the alice forceps.
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The nose is an organ that serves many functions. These functions are intimately involved in an organ that occupies a very aesthetically prominent position on the face. A thorough knowledge of the anatomy is of the utmost importance for surgeons attempting to preserve or improve the functional capability and the aesthetic appearance of the nose. Nasal anatomy is extremely complex with a myriad of different three-dimensional variances. The middle third of the nose has largely been overlooked in its importance. The components of this portions of the nose consist of the paired upper lateral cartilages, the dorsal aspect of the septum, and the scroll of the upper lateral cartilages upon the lower lateral cartilages. This area is of key importance to the nasal valve area and can have a major impact on the functional capabilities of the nose. A description of the confluence of the flare of the septum to the upper lateral cartilages is necessary for an understanding of changes that may occur during rhinoplastic operations. A knowledge of the anatomy of the middle third of the nose may prevent nasal valve collapse, a pinched appearance of this portion of the nose, or an aesthetically unappealing appearance.
Taking good clinical photographs can be simple and fast if a few basic principles are followed. An overview of basic photography with an emphasis on germane principles is followed by brief discussions of equipment, lighting, positioning, and common mistakes. The simplest way to take good photographs is presented. More advanced techniques are also discussed. Finally, attention to details in examining pre- and postoperative photographs is stressed.
The bony nasal vault represents a complex three-dimensional structure, analogous to a truncated pyramid or pyramidal frustrum. By analyzing the nasal bones and determining the length and width of the nasal bones, appropriate surgical measures can be employed. In addition, a review of several different osteotomy techniques is performed.
The Internet has become an important avenue for facial plastic surgeons to make potential patients aware of their practice. It is important for the facial plastic surgeon to understand how the Internet is used by patients and how it can complement a physician's practice. The website unavoidably has a marketing aspect. Although there are no statistics available, certainly a substantial number of patients use the Internet as a primary source for both learning about cosmetic surgical procedures and also to locate a physician. A practice website can provide potential patients with important logistical information; it also provides an opportunity to educate the potential patient about the surgical procedures provided. A website can be an important aspect of the overall practice image. An increasing number of individuals visit the website of their physician or potential physician, so it is important that attention is given to this aspect of a practice.
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The most frequent avoidable mistakes which a young rhinosurgeon commits concern the analysis of the patient's desire, the preoperative critical examination of the facial proportions, the choice of the surgical technique and the operative approach, the choice of the implantation material and the method of how to implant it in a form-fitting manner, overreductions or underreductions by osteotomy and mistakes in the course of postoperative change of the dressings. The way of avoiding these errors and the way of their secondary correction are presented. The principle of a secondary operation is a structural reorientation by a few minor surgical steps.