Simplified Septal Stabilization in Closed-Approach Low-Septal-Resection Dorsal Preservation Rhinoplasty.

Background: Septal fixation is a basic step in low-septal-resection dorsal preservation rhinoplasty. Inadequate septal stabilization can lead to supratip depression or more severe saddle nose deformity. This paper presents a simple surgical maneuver to stabilize quadrangular septal cartilage instead of suture fixation to the anterior nasal spine.

A-T Flap for Reconstruction of Nasal Dorsum Skin Defects.

Reconstruction of nasal defects can be challenging, especially when encountering larger defects. We describe the use of a single-stage conversion of an 'A' shaped defect to a 'T' shaped scar of large nasal skin defects in the cosmetically sensitive supra-tip and supra-alar regions. This study aimed to determine whether an A-T flap is a suitable option for nasal reconstruction and if so where and what size defects it can be used for.

The Effect on Patient Satisfaction of the Postoperative Nasal Topographic, Demographic, and Functional Results of Open and Closed Septorhinoplasty Techniques.

Aim: To evaluate the contribution to patient satisfaction of the newly reshaped topographic anatomy of the nose, demographic, and functional results in the postoperative period of septorhinoplasty surgery.

Method: A total of 370 patients applied with open and closed septorhinoplasty techniques for various reasons were grouped according to the postoperative Rhinoplasty Outcome Evaluation (ROE) Scale results; Group 1 (open rhinoplasty satisfied group, ROE ≥12 points, n:194), Group 2 (open rhinoplasty dissatisfied group, ROE <12 points, n:23), Group 3 (closed rhinoplasty satisfied group, ROE ≥12 points, n:137), Group 4 (closed rhinoplasty dissatisfied group, ROE <12 points, n:16). The groups were evaluated in respect of the effect on patient satisfaction of functional and demographic variables and satisfaction with the topographic outcome of the nose.

Guitar-String Suture to Facilitate Closure of a Finger-like Flap for Reconstruction of the Nose.

Introduction: The basic principle of a lobed or finger-like transposition flap is that, after covering the defect with the transposed tissue, the donor site is closed primarily. With large defects, a second lobe may be added to the flap if primary closure of the area left by the first lobe is not possible. The flap can often be made to adapt to the defect, but this maneuver, in combination with primary closure of the adjacent tissue, can sometimes produce excessive tension and compromise the blood supply.

[Standard rhinoplasty].

Most patients who consult a surgeon for rhinoplasty do not want a radical change in their nose. They seek a reduction in the volume of the nasal pyramid and correction of a precise element that they judge to be ungainly--most often an osteocartilaginous hump. The procedure that we qualify as "standard" will eliminate the osteocartilaginous hump, decrease the dimensions of the septum and reduce the size of the alar crus of the alar cartilage.

No osteotomy rhinoplasty: indications and surgical details.

Unlabelled: Lateral osteotomy is a particular step in rhinoplasty that aims to close an open roof deformity after hump reduction, narrow the lateral walls of the nose, and symmetrically align the nasal bony framework in cases with asymmetry. When the only reason for performing lateral osteotomy is to close an open roof, this can be avoided by using auto spreader flaps. In component hump reduction, the entire length of the upper lateral cartilage is preserved, including the portion under the nasal bone bilaterally.

Dorsal hump surgery and lateral osteotomy.

Lateral osteotomy is a controversial step in rhinoplasty, which is usually performed to narrow a wide nose, widen a narrow bony pyramid, straighten a deviated nose, or close an open roof deformity. The osteotomy is performed using several methods, although the internal continuous and external perforator are the main ways to perform the lateral osteotomy. Most other techniques are modifications of these basic methods.

The rationale for direct linear closure of facial Mohs' defects.

Background: Closing Mohs' defects is a challenging undertaking for surgeons. There are many methods, including linear repair, local flaps, and skin grafts. Traditionally, geometric flaps have been a mainstay, particularly in the cheek and forehead.

Suture techniques for the nasal tip.

The authors use 5 basic suture techniques in tip plasty: transdomal, interdomal, lateral crural mattress, columella-septal, and intercrural, incorporating these techniques into a simple algorithm to control tip cartilage shape. They then introduce the universal horizontal mattress suture, designed to control all undesirable nasal cartilage convexities/concavities, and provide a new suturing technique that can be applied in all patients in whom a change of cartilage shape, including tip cartilages, is desired. They also apply these suture techniques in patients undergoing closed and secondary rhinoplasty.

Open and closed rhinoplasty (minus the "versus"): analyzing processes.

Both open and closed rhinoplasties involve common processes that are impacted by the choice of approach. Careful analysis is necessary to understand how each approach affects the surgeon's assessment of intrinsic anatomy, limits or expands surgical options, and influences the degree of surgical control. According to the author, any surgeon who performs all rhinoplasties using either an open or closed technique exclusively is likely compromising optimal results in some patients.

Nasal anatomy and physiology.

The anatomy and physiology of the internal nose is not always given appropriate consideration when rhinoplastic surgery is performed. Knowledge of the basic physiologic mechanisms of normal nasal function should be a prerequisite to operating on the external nasal structures because of the close relationship between form and function. Although the goals of rhinoplastic surgery are largely to enhance the cosmetic appearance of the visible portion of the nose, it is incumbent upon the surgeon to respect and preserve the critical roles of those portions that remain unseen.

The midfacial degloving procedure for nasal, sinus, and nasopharyngeal tumors.

The midfacial degloving approach is more technically involved than a lateral rhinotomy and requires a basic level of proficiency and understanding of closed rhinoplasty incisions and anatomy of the nose, paranasal sinuses, and skull base structures. Current applications of the midfacial degloving procedure have allowed expansion of indications for this technique through the use of complementary endoscopic and subcranial approaches, permitting the exposure and removal of extensive skull base lesions without disfiguring facial incisions. Fundamental in these approaches is the basic midfacial degloving exposure, which is discussed in this article, along with the applications for treatment of skull base lesions.

Suture techniques in rhinoplasty by use of the endonasal (closed) approach.

The benefits of both the open and closed approaches were combined by use of an extended closed rhinoplasty. It is theorized that circulation would be improved, while providing greater visualization of the tip cartilages for suture techniques in those patients considered at risk for the open approach (e.g.

[The actual problems in functional and aesthetic nasal surgery].

Functional and aesthetic nasal surgery has been undergoing a process of fine-tuning. The surgical approaches lean toward greater conservation-particularly aesthetic- and functional selectivity. This has been made possible by improved diagnostic methods and pre-operative programming techniques such as computerized morphometry, computerized axial tomography, rhinosinus endoscopy, rhinomanometry, acoustic rhinometry and electromyography.