Feeling Normal? Long-Term Follow-up of Patients with a Cleft Lip-Palate after Rhinoplasty with the Derriford Appearance Scale (DAS-59).

The stigma of nasal deformity due to a congenital cleft lip-palate has an undeniable influence on the affected patient's life. It is therefore of interest to investigate if efforts to reduce esthetic and functional impairments by rhinoplasty (single or multiple) can result in an increased satisfaction with appearance and a self-perception similar to the noncleft population. Retrospective scoring before and after rhinoplasty using the validated Derriford Appearance Scale (DAS-59) and subsequent statistical evaluation and comparison to datasets available in the literature for further classification was used.

Differences in cartilage-forming capacity of expanded human chondrocytes from ear and nose and their gene expression profiles.

The aim of this study was to evaluate the potential of culture-expanded human auricular and nasoseptal chondrocytes as cell source for regeneration of stable cartilage and to analyze the differences in gene expression profile of expanded chondrocytes from these specific locations. Auricular chondrocytes in monolayer proliferated less and more slowly (two passages took 26.7 ± 2.

Irradiated homologous rib grafts in nasal reconstruction.

Objective: To assess the long-term efficacy of irradiated homologous rib grafts (IHRGs) for both augmentation and support function in rhinoplasty in general and for specific recipient sites within the nose.

Design: A retrospective study was conducted at an academic medical center to evaluate the loss of volume and support function of IHRGs in 9 specific recipient sites in the nose.

Results: We studied 66 patients, with a total of 177 IHRGs, dating back 9 years, with an average follow-up of 51 months.

Reconstruction of the nasal septum using polydioxanone plate.

Objectives: To evaluate the usefulness of resorbable polydioxanone plate attached to nasal septal cartilage in external septoplasty, to assess its mechanical stability until healing of cartilage fragments, and to describe the surgical technique and clinical experience.

Design: External septoplasty with polydioxanone plate has been performed in 396 patients since 1996. Indications were severe septal deformities (usually posttraumatic).

Revision rhinoplasty: an overview of deformities and techniques.

This article provides an overview of assessment, planning, and correction of deformities in revision rhinoplasty surgery. Common deformities are described with tips for preventing such postoperative problems, and corrective strategies are suggested. Assessment remains the key to successful rhinoplasty surgery, and its importance in revision operations is emphasized.

Open rhinoplasty in children.

Septorhinoplasty in children carries the risk of growth disturbance of the nose and premaxilla. The open or external approach has the advantage that the cartilaginous nasal skeleton remains intact. This open approach enables the surgeon to excise dermoid cysts and to realign lower lateral cartilages (unilateral cleft) without disturbing the integrity of the cartilaginous skeleton.

Pediatric rhinoplasty in an academic setting.

Nasal septal surgery and rhinoplasty are controversial in children. Traditionally, an attitude of restraint has been employed by most surgeons till an empirical age of 16 to 18 years. This is to avoid the possible adverse effects that the growth spurts may have on the nose and midface region.

Treatment of septal hematomas and abscesses in children.

The cartilaginous part of the nasal septum of a child with a septal hematoma or abscess is at risk of destruction. Consequently, the noses of these children can collapse, causing a saddle nose deformity, and in time, the normal outgrowth of both the nose and maxilla will be disturbed. In adulthood, they will have an underdeveloped saddle nose deformity with too much upward rotation of the nasal tip and a retroposition of the midface.

Morphological and histological findings after typical surgical manipulations on growing septal cartilage in rabbits.

One remaining problem of nose surgery is surgical correction of a prepubertal distortion of the septum. Unfortunately, the growing cartilage reacts differently upon a surgical intervention; in most cases this might cause iatrogenic disturbance of the development. Our clinical and histological studies with polydioxanone (PDS) foil in septal reconstruction showed that the PDS foil successfully prevented postoperative sequelae like dislocation of the reimplanted cartilage fragments and recurrent deviation caused by overlapping of the cartilage borders.

Long-term patient satisfaction after revision rhinoplasty.

Objective: In cases of dissatisfaction after rhinoplasty for esthetic or functional reasons, or both, revision rhinoplasty may be advocated to improve the patients' nasal performance. In contrast to studies on primary rhinoplasty, no objective outcome evaluation parameter has been validated in revision rhinoplasty, nor has there been a study specifically looking at long-term satisfaction after revision rhinoplasty. We aim at studying patient satisfaction after a long-term follow-up of revision rhinoplasty performed at an academic referral center.

Reconstructive surgery of the leprosy nose: a new approach.

There has still been no reduction in the detection rate worldwide for leprosy, despite supervised multi-drug therapy. In time, leprosy can result in a severe saddle-nose deformity leading to functional problems, disfiguration and stigmatization. In severe cases, only the nasal skin tissue and the lower lateral cartilages are preserved.

Reconstructive septal surgery.

To attain without compromise the surgical goal, a straight and concurrently solid septum, especially in cases of marked deviations or severe post-traumatic deformities (sometimes combined with external deformities), an excellent proven and well-known technique is extracorporal or external septoplasty. Surgery consists of excision of the quadrilateral cartilage and its division into straight fragments. To avoid postoperative sequelae such as saddling, the pieces of cartilage must be reconnected meticulously to form a straight and at the same time solid plate.

Postoperative management of nasal vestibular stenosis: the custom-made vestibular device.

Objective: To evaluate the effect of a custom-made postoperative vestibular device on the occurrence and severity of restenosis.

Design: This was a retrospective study conducted at the Department of Otorhinolaryngology/Head and Neck Surgery, Center for Facial Plastic and Reconstructive Surgery of the Academic Medical Center. In this tertiary care center between January 1994 and December 2000, 52 patients treated for nasal vestibular stenosis received a vestibular device directly postoperatively, with the intention to decrease the risk of restenosis.

Objective computerized determination of the minimum cross-sectional area of the nasal passage on computed tomography.

Objectives/hypothesis: Current methods that measure cross-sectional areas of the nasal passage on computed tomography (CT) do not determine the minimum cross-sectional area that may be an important factor in nasal airway resistance. Objective measurement of the dimensions of the nasal passage may help in the diagnosis, as well as the choice and evaluation of surgical treatment for upper airway insufficiencies.

Study Design: Retrospective and clinical study.

Interest in facial plastic and reconstructive surgery among otorhinolaryngologists: a survey in The Netherlands.

Objective: To assess the interest of Dutch otorhinolaryngologists in facial plastic and reconstructive surgery (FPRS).

Methods: We conducted a 22-question survey among otorhinolaryngology physicians and residents concerning their experience with and interest in FPRS. The response rate was 71% (335/475; 275 physicians and 60 residents).

Otoplasty: a modified anterior scoring technique.

In the long history of otoplasty, the basic techniques used to correct prominent ears with a missing antihelix are based on incisions, scoring, and suturing of the cartilaginous framework of the auricle. In this article, modifications (subperichondrial dissection and adjusting sutures) of the anterior scoring technique of Chongchet are described.

Considerations on the use of ear chondrocytes as donor chondrocytes for cartilage tissue engineering.

Articular cartilage is often used for research on cartilage tissue engineering. However, ear cartilage is easier to harvest, with less donor-site morbidity. The aim of this study was to evaluate whether adult human ear chondrocytes were capable of producing cartilage after expansion in monolayer culture.

Considerations in ethnic rhinoplasty.

Although it is difficult to define specific ethnic groups as they are multiracial mixtures determined by historical, geographical, and cultural factors, we can define basically five non-Caucasian groups that commonly request rhinoplasty. The specific anatomy, surgical options, implant material, grafts, and possible complications are discussed. The importance of blending the "new" nose with the ethnic features to achieve harmony in the facial aesthetic components is emphasized.

Influence of polydioxanone foil on growing septal cartilage after surgery in an animal model: new aspects of cartilage healing and regeneration (preliminary results).

Objective: To determine whether late complications after septoplasty in growing septal cartilage in children can be prevented by the use of a resorbable polydioxanone (PDS) foil in combination with the cartilage.

Design: Animal study with 45 young rabbits, operated on at the nasal septum. Four typical septoplasty procedures were carried out, including elevation of the mucoperichondrium, cartilage excision, and reimplantation of crushed and noncrushed cartilage; for each of the procedures, resorbable PDS foil was used in half of the animals.

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.