Septorhinoplasty for the crooked nose

The externally deviated nose represents a complex cosmetic and functional problem. Its correction remains one of the challenging problems in rhinoplasty. To evaluate the result of correction of crooked nose by septorhinoplasty with fixation of nasal septum to the anterior nasal spine. 54 patients have undergone primary septorhinoplasty through a closed approach including full mobilization of the septal cartilage, osteotomy to reduce the displaced lateral nasal wall and finally fixing the septal cartilage to the anterior nasal spine. The minimum follow-up period was 6 months. Recurrence rate for nasal deviation 10%. The aesthetic results were considered good to excellent in all patients, as judged by both the surgeons and patients. Complete mobilization of septal cartilage without scoring along with its fixation to the anterior nasal spine is satisfactory for correcting crooked nose

Closure of A large complicated pharyngocutaneous fistula

Pectoralis major muscle or myocutaneous flap is usually used for closure of big pharyngocutaneous fistula. In case of partial or complete failure, the plastic surgeon should be well prepared to use a second option for closure weather using myocutaneous or fasciocutaneous flaps, alone or with combination. Deepithelialized Deltopectoral flap found to be a reliable option