Improvement of nasal breathing in cleft patients following midface osteotomy.

In 20 adult cleft patients, the influence of a Le-Fort-I-osteotomy and ventral-caudal advancement of the maxilla on nasal breathing was studied. An increase of nasal air flow in the majority of patients is due to an increase in the volume of nasal skeleton and/or in the nasolabial angle and alar nasal base. Rhinomanometric measurements and X-ray examination confirm the results.

[Management of septal perforations by rotationplasty of the septal mucosa].

A unilateral mucosal flap from the septum with a wide pedicle and an axial blood supply was used for closure of septal perforations. In special cases this procedure was combined with a labial-buccal flap. 18 patients with perforations of different sizes were treated resulting in a permanent and complete closure in 12 cases.

[Treatment of choanal atresia].

17 unilateral and 6 bilateral choanal atresias in children were observed in the ENT-Dept. of the University Hospital Erlangen during 1975-1982. Bilateral choanal atresia requires immediate trepanation by using the CO2 or Argon laser technique.

On the improvement of nasal breathing following mid-face osteotomies, and possible reasons for the phenomenon.

In the great majority of patients with hypoplasia of the middle third of the face, the surgical advancement or displacement of the maxilla results in a subjective improvement in nasal breathing, which can also be verified. This is due to an increase in the volume of the nasal skeleton and/or in the nasolabial angle, which improves nasal ventilation. These operations have virtually no effect on endonasal obstructions to flow, which, in order further to improve nasal breathing, should be dealt with separately.

Electromyography in rhinoplasty.

The function of the nasal muscles in rhinoplasty has not been investigated sufficiently. On this reason electromyographical and neuromyographical investigations were done in a group of rhinoplastics before and immediately after surgery but also at least 8 weeks later on. By performing a conservative technique the initial disturbance of the muscles immediately after surgery disappears in a high percentage and voluntarily movements of the nasal muscles can be observed.