Measurement of Hunan Han young female nasal shape and its application for short nose rhinoplasty / 中华整形外科杂志

Objective@#To explore the measurement of Hunan Han young female nasal shape and its application for short nose rhinoplasty.@*Methods@#From June to December 2015, 162 Han young females in Hunan Xiangtan were chosen. Their photographs were used by the photogrammetry for measuremnet of nasal length, nasal height, nasal breadth, nasal depth, nasolabial angle, nasofrontal angel, nasorostral angel, columellar-facial angle, nose width-nose height index, nasal depth-nose width index, nasion to tip-defining point. The measurementresult were collected to create nasal shape database. During the period of January to June 2016, the database was applied to thirty-nine cases with short nose, to serve as guidelines for preoperative design and postoperative evaluation. Independent sample t-test was used to evaluate theresult of the operations by comparing the postoperative data with the nasal shape database of Hunan female nose assessment system.@*Results@#The measurementresult of Hunan Han young female nasal shape were as follow: nasal length (4.4±0.2) cm, nasal height(4.8±0.2) cm, nasal width (3.3±0.2) cm, nasal depth (1.8±0.2) cm, nasolabial angle (88.6±7.0)°, nasofrontal angle (136.0±5.5)°, columellar-facial angle (33.3±3.0)°, nasal tip angle (82.4±5.4)°, nose width-nose height index 70.4±4.8, nasal depth-nose width index 55.1±5.7, nasion to tip-defining point (47.4±11.4)%.The short noses deformity was corrected greatly. The measurement data of nasolabial angle, nasofrontal angel, nasorostral angel, columellar-facial angle, nose width-nose height index, nasal depth-nose width index and nasion to tip-defining point had no statistical significance between postoperative patient and Hunan female, but nasal length, nasal height, nasal width and nasal depth difference have statistical significance.@*Conclusions@#The Hunan Han young female nasal shape database could provide quantitative reference for preoperative design, performance and post-operative aesthetics evaluation.

Corrective Rhinoplasty with Combined Use of Autogenous Auricular Cartilage and Porcine Dermal Collagen in Cleft Lip Nose Deformity / 대한악안면성형재건외과학회지

Esthetic reconstruction of cleft lip nose deformity is a challenging task in surgical management of patients with orofacial cleft. The author reconstructed cleft lip nose deformity effectively using autogenous auricular cartilage and a relatively new graft material of porcine dermal collagen, Permacol(TM). After correction of the deformed lower third of the nose with patient's auricular cartilage, we applied Permacol(TM) to augment the entire nasal dorsum. Three patients were treated and followed for up to five years. All patients improved in nose aesthetics without any inflammatory or immunogenic reaction. The author suggests that the use of Permacol(TM) for nasal profile augmentation in the treatment of cleft lip nose deformity is an alternative surgical strategy with minimal surgical invasiveness. The author report long-term experience with combined use of auricular cartilage and Permacol(TM) in nasal reconstruction for cleft lip nose deformity.

Herpes Simplex Virus Infection after Corrective Rhinoplasty through External Approach: Two Case Reports

PURPOSE: Eczema herpeticum, caused by herpes simplex virus, is an infectious disease involving skin and internal organs. Varieties of physiologic, psychosocial, or environmental stress reactivate reservoir virus which exists in the trigeminal nerve ganglia. Authors report rare cases of nasal eczema herpeticum following corrective rhinoplasty. METHODS: First case, 22-year-old female underwent corrective rhioplasty through an external approach in a local clinic. She developed progressive and painful erythema, nodules and vesicles on nose on the 9th day postoperatively. This unfamiliar lesion lead to a misdiagnosis as a bacterial infection, and had accelerated its progress to the trigeminal innervation of the nasal unit. Second case, a 23-year-old female underwent corrective rhinoplasty by external lateral osteotomy. Ten days after the surgery, disruption occurred on the external osteotomy site, and the ulceration gradually worsened. The surgeon misdiagnosed it as secondary bacterial infection and only an antibacterial agent was applied. RESULTS: Both cases were healed effectively without any complication with proper wound dressing and antiviral therapy, and show no sequelae during an 8-month follow-up period. CONCLUSION: Eczema herpeticum is rare in the field of plastic surgery, but it should be kept in mind that secondary bacterial infections may lead to serious complications such as full-thickness skin loss. Thus, acknowledgement of the patient's past history regarding perioral or intraoral lesion may provide the surgeon with the possible expectancy of eczema herpeticum. Thus, if anyone develops eczema herpeticum, following facial plastic surgery, early diagnosis and immediate proper antiviral therapy will allow fast recovery without serious complications.

Herpes Simplex Virus Infection after Corrective Rhinoplasty through External Approach: Two Case Reports

PURPOSE: Eczema herpeticum, caused by herpes simplex virus, is an infectious disease involving skin and internal organs. Varieties of physiologic, psychosocial, or environmental stress reactivate reservoir virus which exists in the trigeminal nerve ganglia. Authors report rare cases of nasal eczema herpeticum following corrective rhinoplasty. METHODS: First case, 22-year-old female underwent corrective rhioplasty through an external approach in a local clinic. She developed progressive and painful erythema, nodules and vesicles on nose on the 9th day postoperatively. This unfamiliar lesion lead to a misdiagnosis as a bacterial infection, and had accelerated its progress to the trigeminal innervation of the nasal unit. Second case, a 23-year-old female underwent corrective rhinoplasty by external lateral osteotomy. Ten days after the surgery, disruption occurred on the external osteotomy site, and the ulceration gradually worsened. The surgeon misdiagnosed it as secondary bacterial infection and only an antibacterial agent was applied. RESULTS: Both cases were healed effectively without any complication with proper wound dressing and antiviral therapy, and show no sequelae during an 8-month follow-up period. CONCLUSION: Eczema herpeticum is rare in the field of plastic surgery, but it should be kept in mind that secondary bacterial infections may lead to serious complications such as full-thickness skin loss. Thus, acknowledgement of the patient's past history regarding perioral or intraoral lesion may provide the surgeon with the possible expectancy of eczema herpeticum. Thus, if anyone develops eczema herpeticum, following facial plastic surgery, early diagnosis and immediate proper antiviral therapy will allow fast recovery without serious complications.

Lateral Osteotomy with Sawing Technique in Open Rhinoplasty

PURPOSE: Lateral osteotomy is an essential step in the correction of nasal bony asymmetry. Direct visualization allows accurate repositioning of the nasal bones compared to blind techniques, which require precision and manual dexterity. We propose direct visualization procedures in open corrective rhinoplasty. METHODS: The technique was used on 16 patients. All patients underwent open rhinoplasty with a columellar incision. The marginal incisions were extended on either side to allow access to the piriform aperture. A double hook was used to caudally retract the lower lateral cartilages and the fibrous connections between the upper and lower lateral cartilages were released until the piriform aperture was visualized. Through the incision, lateral osteotomy was performed using a reciprocating saw at that time with direct visualization. Additional procedures including augmentation rhinoplasty, hump resection, septoplasty and tip plasty were performed simultaneously. RESULTS: This method provided excellent exposure to the lateral nasal bones and allowed the lateral osteotomy to be carried out precisely using the reciprocating saw. CONCLUSION: This extended open rhinoplasty method is suitable for most individuals, allowing a wide surgical field.

Corrective Rhinoplasty for Deviated Nose a New Osteotomy Technique

PURPOSE: Posttraumatic nasal deformities might not be corrected adequately by conventional osteotomy techniques when the configuration of the nasal bone has been changed due to malunion. To consistently obtain good aesthetic and functional results, the anatomic reduction of malunion sites of the nasal bone is important. The purpose of this study is to present an osteotomy technique, including refracture along malunion sites and anatomical reduction of a malformed nasal bone, for the correction of a posttraumatic deviated nose. METHODS: From March of 2003 to May of 2004, 27 patients, who underwent corrective rhinoplasty for the correction of bony pyramid deviation, were included in this study. Postoperative results of the technique were evaluated objectively at 1 year after surgery regarding nasal midline location, nose symmetry, and nasal contour. Results were rated as excellent, good, fair, or poor. All patients were also evaluated subjectively for cosmetic improvement, changes in breathing, and overall satisfaction. RESULTS: Objective analysis of the outcomes revealed an excellent result in 17 patients(63%), good in 9(33%), and fair in 1 patient(4%). No case evaluated had a poor result. Regarding subjective analysis, 19 patients(70%) evaluated the cosmetic outcome as perfect. Among the 21 patients with preoperative airway problems, 19 patients(90%) reported improved breathing post-operatively. Patients' overall satisfaction levels were also very positive. No postoperative complications occurred during the 14 month mean follow-up period. CONCLUSION: The osteotomy technique presented in this study is simple, effective, and safe for correcting posttraumatic nasal deviation, and also produces consistent results.

Septoplasty Through Dorsal Approach

Septal deviations interfere with the nasal airflow and contribute to the deformities in the external appearance of the nose. An aesthetically and functionally satisfactory correction of severe septal deformities often requires temporary intraoperative removal of the septal cartilage for appropriate remodeling. This article describes septoplasty through dorsal approach for the correction of septal deviation. From March 2001 to April 2004, the author performed septoplasty through dorsal approach for the correction of septal deviations on 45 patients, of whom 22 of whom had nasal obstruction. Open rhinoplasty was used for dorsal approach in all patients and operation was performed under the general anesthesia or local anesthesia. The follow-up period of the patients ranged from 3 to 15 months with a mean of 10 months, and postoperative results were quite satisfactory. There was neither incidences of patients' complaints, nor any complications such as hematoma, septal perforation, supratip deformity, or recurrence. And there was some improvement of nasal obstruction in 15 patients. In conclusion, Septoplasty through dorsal approach is an effective method for the correction of septal deviation and improvement of the nasal airway obstruction.

Analysis of Long Term Result and Satisfaction after Corrective Rhinoplasty

Since the nose is the most prominent and impressive part in the face, plastic surgeons try to make an ideal nose. Thus, plastic surgeons can aid patients to make significant psychosocial changes in their lives. 104 of 132 patients who received corrective rhinoplasty were requested to answer the study designed to assess their satisfaction and psychological reactions to the operation. Preoperatively, patients filled out a questionnaire about their expectations, relationships, self-confidence, self-esteem, and so on. Postoperatively, they completed a similar questionnaire. Preoperative and postoperative information was also obtained from the surgeons and nurses. 81% of the patients expected that rhinoplasty would change their lives. And 96% of the patients were satisfied with the results. The surgeons were usually more critical about the surgical results than the patients. A number of patients had increased self-confidence and self-esteem. These findings would be useful in understanding of postoperative satisfaction and psychological reactions after corrective rhinoplasties.

The Complicated Changes of External Nose after Corrective Rhinoplasty / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Rhinoplasty is not a simple technique but a series of interrelated, interdependent surgical maneuvers performed consequently. Each maneuver should be calculated to correct the total nasal deformity by creating a series of small defects or repositioning various anatomic components that must ultimately fit together. The purpose of this study is to review undesirable complicated changes that occur in the external nose following corrective rhinoplasty and to provide useful reference for better practice in rhinoplasty. MATERIALS AND METHODS: We have carried out 42 cases of corrective rhinoplasty from January, 1994 to December, 1998. We have observed complicated changes of the external nose after corrective rhinoplasty by conducting serial photogaphic documentation and analyses, questionnaires which were answered by the patients and the surgeons. RESULTS: We analyzed the various undesirable complicated changes and found out that the most common changes were widening of the nasal dorsum. The major causes of this nasal widening were the failure of perfect osteotomy, inadequate postoperative contouring, aging process of patients' nose, and the lack of ability of surgeon to predict the healing dynamics. CONCLUSION: To prevent and to minimize such undesirable changes following corrective rhinoplasty, surgeons need to gain skillful surgical techniques and adequate postoperative contouring skills. Most importantly, a thorough appreciation and understanding of the healing dynamics of rhinoplasty should be recognized.

Clinical Experiences of Rhinoplasty with Patients' Assessment of the Results / 대한이비인후과학회지

BACKGROUND AND OBJECTIVE: The aim of this study is to investigate patients' satisfaction following rhinoplasty through analyzing questionnaires. MATERIALS AND METHODS: Study materials were 69 patients who underwent rhinoplasty at the Department of Otorhinolaryngology, Asan Medical Center, between 1989 and 1996. Causes of nasal deformities, applied surgical procedures, and postoperative complications were retrospectively investigated by reviewing medical records, and patients' satisfaction was investigated through analyzing questionnaires about cosmetic and functional outcomes. RESULTS: Silastic implants were used to augment the flat nose in 35 patients, and were extruded in four patients (11%). Thirty-six (52%) of 69 patients replied to the questionnaires. The results of patients' self-assessment were satisfactory (15 patients: 41.5%), fair (6 patients: 17%), and unsatisfactory (15 patients: 41.5%). There was no significant difference in the satisfaction rate between patients undergoing augmentation rhinoplasty and those undergoing corrective rhinoplasty. Young male patients (10-29 years in age) were much more unsatisfactory with surgical results than the rest of the male patients (67% vs. 11%) Twenty-six patients of 36 responders to the questionnaires underwent concomitant septoplasty and 22 (85%) of them answered that their breathing function was improved postoperatively. CONCLUSION: These results indicate that we failed to meet the patients' expectation for cosmetic improvement. Hence, improving surgical skills of the surgeons and explaining the patients preoperatively about limitations and possible unsatisfactory outcomes are needed.

A Clinical Analysis of Corrective Rhinoplasty in the Nasal Derormity

No abstract available.

Endoscopic-assisted correction of deviated nose

Owing to the complexity of the deviated structures and the septal deformities accompanying the external nasal deformities, the complete correction of the deviated nose is regarded as a difficult one. The approach to the nasal bone and osteotomy in classic corrective rhinoplasty is almost blind technique, where the results depends on the feeling by surgeon's hand. To overcome these drawback, endoscopic-assisted corrective rhinoplasty and septoplasty performed for 8 cases of deviated nose between January 1996 and May 1997. Average follow-up period was 10 months. All patients were evaluated by symmetrical nasal pyramid, recurrence of the bony deflection and septal deviation. The postoperative courses were satisfactory in most of cases with few complications. It appears that endoscopic control during corrective rhinoplasty and septoplasty is a big step toward obtaining better results in bony and cartilage resection with extreme precision under monitor control and magnification. This technique is not an open approach but permits one to see more of the nasal skeleton and bony septum what is causing deformity, and the immediate effect of the corrective measures used. The use of endoscope in corrective rhinoplasty will provide expanded field of vision, direct manipulation of lesions, and better aesthetic an6 functional results.

Endoscopic-assisted correction of deviated nose

Owing to the complexity of the deviated structures and the septal deformities accompanying the external nasal deformities, the complete correction of the deviated nose is regarded as a difficult one. The approach to the nasal bone and osteotomy in classic corrective rhinoplasty is almost blind technique, where the results depends on the feeling by surgeon's hand. To overcome these drawback, endoscopic-assisted corrective rhinoplasty and septoplasty performed for 8 cases of deviated nose between January 1996 and May 1997. Average follow-up period was 10 months. All patients were evaluated by symmetrical nasal pyramid, recurrence of the bony deflection and septal deviation. The postoperative courses were satisfactory in most of cases with few complications. It appears that endoscopic control during corrective rhinoplasty and septoplasty is a big step toward obtaining better results in bony and cartilage resection with extreme precision under monitor control and magnification. This technique is not an open approach but permits one to see more of the nasal skeleton and bony septum what is causing deformity, and the immediate effect of the corrective measures used. The use of endoscope in corrective rhinoplasty will provide expanded field of vision, direct manipulation of lesions, and better aesthetic an6 functional results.

Corrective Rhinoplasty Through the Correction of Combined Deformities / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Recently, the demand for corrective rhinoplasty has increased due to a higher frequency of accidents as well as improved socioeconomic status. Thus, there is an increased interest in the correction of deviated noses in the otorhinolaryngologic field. This study offers a clinical analysis of our experiences in the corrective rhinoplasty and makes a case that the simultaneous correction method by the exteral approach is suitable for combined deformities of the nose. MATERIALS AND METHODS: A retrospective study was performed on 69 patients who underwent corrective rhinoplasty during the last four years. Initially, patients were put under general anesthesia, and the procedures were performed through the external approach. Following the initial corrective rhinoplasty was a simultaneous correction of combined deformities of the nose such as deviated noses with saddle deformity or hump nose or camouflage of the deviation with one or two straight layered cartilage on the nasal dorsum. RESULTS: Satisfactory results were achieved in most cases except in the two cases of incomplete correction, one case of cosmetical unsatisfaction and one case of intermittent nasal obstruction. CONCLUSION: Deviated noses frequently have combined deformities. For better results, it is necessary to correct combined deformities simultaneously. The authors obtained satisfactory results through simultaneous correction of complicated deformities using the external approach.