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Objective:To measure and analyze the morphological parameters of nasal septal cartilage obtained by rhinoplasty in Chinese, so as to provide theoretical guidance for clinical acquisition and application of nasal septal cartilage.Methods:From March 2014 to June 2021, 732 patients were received rhinoplasty in Myoung Beaucare Clinic of Beijing-Cosmetic Surgery. During the operation, 12 mm L-shaped nasal septal cartilage scaffold was obtained from nasal septal cartilage for transplantation. Measurement of the length, width, area, maximum thickness and minimum thickness of nasal septal cartilage was performed for further analysis.Results:For nasal septal cartilage obtained from comprehensive rhinoplasty, its length was 1.2 to 3.5 cm, with an average of 2.16 cm; the width was 1 to 3 cm, with an average of 1.84 cm; the area was 1.43 to 10.5 cm 2, with an average of 4.04 cm 2, with a maximum thickness of 0.5 to 3 mm, with an average of 1.92 mm and a minimum thickness of 0.2 to 0.5 mm, with an average of 0.92 mm. Conclusions:In the comprehensive rhinoplasty of nasal septal cartilage for Chinese, the 12 mm L-shaped nasal septal cartilage scaffold is retained, and the average length, width and area of nasal septal cartilage for transplantation are 2.16 cm, 1.84 cm, 4.04 cm 2, 1.92 mm and 0.92 mm respectively.
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Objective:To investigate the surgical method and clinical outcome of using nasal septal cartilage combined with auricular cartilage for management of nasal tip shape.Methods:A clinical study was conducted from April 2014 to June 2019, in which we managed nasal tip shape with nasal septal cartilage and auricular cartilage, and these materials were used as septal extension graft, spreader graft and cap graft. In total, 622 patients (28 males, 594 females; age from 18 to 42 years, mean age 27.47 years) were assessed for eligibility.Results:The follow-up period was from 6 months to 6 years. Nasal shape of all 622 patients was improved significantly after the operation. The nasal tip was natural and round, and there were no complications such as damage of nasal septum mucosa, exposure of prosthesis and infection of surgical site. Only 12 patients were found downward rotation of nasal tip, and 610 patients achieved satisfactory aesthetic results.Conclusions:Using septal cartilage combined with auricular cartilage is a safe, effective and suitable method for management of nasal tip shape.
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Introduction: Leprosy is a chronic infectious granulomatous disease caused by Mycobacterium leprae, also known as Hansen’sdisease. The disease affects the peripheral nervous system, skin, and mucous membrane. Dissemination and transmission ofM. leprae are primarily from nasal mucosa of infected persons.Materials and Methods: A record-based retrospective observational study was done in the Department of Dermatology andENT, ASCOMS Hospital, Jammu, Jammu and Kashmir, to know the prevalence of otorhinolaryngological manifestations ofleprosy using records of 49 leprosy patients retrieved for 5 years from 2013 to 2018.Results: Forty-nine patients with 40 (82%) males and 9 (18%) females were included in the study having male–to-female ratio4.5:1. A majority of the patients (47%) were in the age group of 20–40 years. Forty-seven (96%) patients had a multibacillarytype of leprosy, while only 2 (4%) patients had paucibacillary leprosy. Seven (14%) patients showed reaction. Four (8%) showedtype I and 3 (6%) showed type II reaction. Nasal manifestations were predominantly encountered among the otorhinolaryngealmanifestations. All the otorhinolaryngeal manifestations were in the multibacillary type of leprosy. The main nasal symptomswith which patients presented were nasal stuffiness (14%), crust formation (8%), and recurrent mild epistaxis (6%). On anteriorrhinoscopy, mucosal changes (pale mucosa and edema) and nasal crusting were seen in 7 (14%) patients, atrophic conchawas seen in 3 (6%) patients and ulceration of the septal perforation was seen in 2 (4%) patients. Saddle nose deformity wasseen in 1 patient. Among the otological manifestations, two patients had erythematous nodules on pinna, while diffuse infiltrationof ear lobules was noted in five patients. Labial edema was seen in two patients and nodular lesion on the lip in one patient.Conclusion: Among the otorhinolaryngological manifestations, nasal involvement was the most commonly seen in leprosypatients. An otolaryngological examination should be routinely done in the diagnosed patients of leprosy
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Objective To explore the clinical effect of double M-shaped cartilage used in nasal tip cosmetic plasty.Methods From December 2016 to May 2017,nasal fip plasty was performed in 39 patients in Hangzhou Huashan Luyeme Medical Cosmetology Hospital.With the Goodman's incision in the columella and nasal vestibule,a big piece of autologous nasal septal cartilage was removed and transplanted to the front of nasal septum.Ear cartilage was trimmed into two strips and sutured with nasal septum cartilage graft.Meanwhile,the sandwich cartilage graft was inserted between the lower lateral cartilages to form the first "M" shape stent when fixing part of it on the nasal septum.Then the ear cartilage was turned over and fixed with lateral crus of the lower lateral cartilages to form the second "M" shape stent.Willow-shaped prosthesis was placed into the nasal dorsum.Results A total of 39 cases of nasal tip surgery were performed,including 1 male and 38 females.Ages ranged from 21 to 48 years in this group.The follow-up period was from 1 month to 5 months.36 patients were satisfied with the efficacy while 2 patients were suffered from the deviation of nasal tip,one patient was suffered from nasal septum deviation.Conclusions The application of double M-shaped cartilage in nasal tip cosmetic plasty is one of ideal rhinoplasty approaches with less wound,simple procedure and good clinical effects.
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Objective To study the surgical method of comprehensive correction of secondary unilateral cleft lip nasal deformity using autologous cartilage and supported by septum cartilage and its outcomes.Methods Our surgery adopted an open approach,fully revealed the deformed alar cartilage and deviated nasal septum cartilage.Part of the nasal septum was removed and made it into various cartilage grafts to repair and reconstruct the columella,nasal tip,nasal alar and nasal dorsal by implanted in the corresponding positions.Results 18 patients with congenital unilateral cleft lip nasal deformity underwent the corrective and reconstructive surgery.The postoperative follow-up was 6-12 months,showing that the malformed nasal appearance came back to normal without obvious scar.The 18 patients did not have associated complications.Conclusions The surgery with a supplementary septal graft achieves good effect,the overall appearance of the malformed nose gets obvious changes,and therefore patients and their families are satisfied with the postoperative nasal shape.
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Costal cartilage, auricular cartilage and nasal septal cartilage are widely used in plastic operation. Costal cartilage is used in ear reconstruction and augmentation rhinoplasty, while the auricular cartilage and nasal septal cartilage are applied in the nasal plastic operation. The maintenance of postoperative form is closely related to the biomechanical characteristics of the cartilage. Meanwhile, ultrastructure, especially extracellular matrix, determines the mechanical properties of cartilage. This review mainly focuses on the biomechanical properties and ultrastracture of the cartilages and summarizes the basic data of different cartilages in biomechanical testing, including tissue engineered-auricular cartilage. However, the procedure of biomechanical testing on cartilages currently needs further standardization, and the use of the finite element method should be promoted, so as to offer a better clinical diagnosis and treatment.
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Objective To correct the nasal deformities of cleft lip by expanded-polytetrafluoroe thylene (e-PTFE) combined with autologous nasal septal cartilage.Methods e-PTFE was placed nearby verge of anterior nasal aperture to raise the fundament of nose.Autologous nasal septal cartilage was harvested and combined with e-PTFE to form a sandwich structure.Nasal tip and collapsed nasaI alar were repaired by this method.Results Fifty cases were treated by this method and 42 cases were followed up for about one year.The results were satisfying.The contour of the nose was similar to normal.Only 3 cases were relapsed after one year.Conclusions e-PTFE combined with autologous nasal septal cartilage is an ideal method to correct nasal deformities of cleft lip.
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Objective To explore the application and efficacy of autogenous septal cartilage in the correction of cleft lip nasal deformity.Methods A total of 31 patients with secondary nasal deformity of cleft lip were involved in this study.After autologous nasal cartilage was released,the dislocation of nasal cartilage was corrected,nasal septum cartilage was used as substitute to raise the alar collapse,to reshape the nasal tip cartilage structure and correct the nasal deformity.Results Postoperative incision was primarily healing.For cartilage donor area there was no serious complications,and incision scar was concealed and unobvious; after 6 months to 2 years follow-up,there was no cartilage absorption deformation,the tip of the nose was flat,crack side nosewing collapses,and nasal columella skew was totally corrected,with stable rhinoplasty effects.Conclusions For secondary nasal deformity of cleft lip,the use of nasal septum cartilage to repair nose deformity can not only solve the cartilage source,but also give septal straightening and at the same time the correction effect of external nasal deformity is good.
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Objective To employ autologous septal cartilage grafting as a new method of elongating the nose and adjusting the nasolabial angle in order to correct the deformities of short nose and bulbous tip.Methods A set of techniques,including,yet not limited to,releasing and sculpturing of the alar cartilages,harvesting of septal cartilages and carving them into L shape and cap-like shape for transplant,moulding the soft tissue envelop with buried through and through sutures etc.were used to lengthen the nose and modify the tip.Results From 2004 to now,the new technique had been applied to 345 patients with short nose and bulbous tip.Follow-up ranged from 6- 48 months,satisfactory outcomes were obtained.Conclusions The new technique adopted by the author in which autologous septal cartilages are settled to the anterior angle of the nasal septum and between the domes of alar cartilages has been proved to be a viable and reliable way to lengthen the nose.Further advantages of this technique include the easiness of harvesting grafts,minimal injury,rare complications of infection and rejection etc.
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Objective To evaluate the role of autologous septal cartilage in the rhinoplasty of the wide and bulbous nasal tip. Methods A big piece of autologous nasal septal cartilage was removed and transplanted to the front of nasal septum, acting as a septal extender to fix the nasal alar cartilage,and then the shape of nasal tip was reconstructed by middle crus suture technique, excessive soft tissue under skin of tip and a part of lateral crura cartilage were removed to stand out the shape of the nasal tip. Results After one year follow-up, 118 of 126 cases achieved satisfied effects, but 8 cases dissatisfied because of their undue thick skin. Conclusions This method is reliable in the correction of the wide and bulbous nasal tip.
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OBJECTIVES: A persistent insufficiency of glottal closure is mostly a consequence of impaired unilateral vocal fold movement. Functional surgical treatment is required because of the consequential voice, breathing and swallowing impairments. The goal of the study was to determine the functional voice outcomes after medialization thyroplasty with using autologous septal cartilage from the nose. METHODS: External vocal fold medialization using autologous nasal septal cartilage was performed on 15 patients (6 females and 9 males; age range, 30 to 57 years). Detailed functional examinations were performed for all the patients before and after the surgery and this included perceptual voice assessment, laryngostroboscopic examination and acoustic voice analysis. RESULTS: All the patients reported improvement of voice quality post-operatively. Laryngostroboscopy revealed almost complete glottal closure after surgery in the majority of patients. Acoustic and perceptual voice assessment showed significant improvement post-operatively. CONCLUSION: Medialization thyroplasty using an autologous nasal septal cartilage implant offers good tissue tolerability and significant improvement of the subjective and objective functional voice outcomes.
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Female , Humans , Acoustics , Cartilage , Deglutition , Laryngoplasty , Paralysis , Respiration , Vocal Cords , Voice , Voice QualityABSTRACT
Objective To evaluate the role of autologous septal cartilage in nasal tip augmentation.Methods Under local anesthesia,nasal tip was exposed using a"bird-wing"incision.The hypertrophic tissue at the nasal tip was removed.Nasal septal cartilage(2 cm × 1 cm)was harvested.The cartilage was used to augment the nasal tip and nasal alar cartilage.Meanwhile,the cartilage was inserted between the nasal alar cartilages to elevate the nasal tip.Results Among 15 cases,13 were followed after operation.The shape of nasal tip improved at different level.The results were satisfying.Conclusion Compared with other materials,the autologous septal cartilage is an ideal material for nasal tip augmentation without rejection effect.
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BACKGROUND AND OBJECTIVES: The histologic difference of the traumatic nasal septal cartilage from that of non-traumatic has not been extensively studied. The aim of this study was to identify histologic difference in the nasal septal cartilage between traumatic and non-traumatic nasal septal deviation and to find its implication for surgical intervention. SUBJECTS AND METHOD: Nasal septal cartilage was obtained from 23 patients who had undergone septoplasty or septorhinoplasty for the nasal septal deviation. The septal cartilage without trauma (7 patients, Group I) and with the history of the trauma at the age under 10-15 years old (8 patients, Group II), and over 25 years old (8 patients, Group III) between May 2003 to February 2005 were included in this study. An approximately 1 x 1 cm sized piece of the septal cartilage was harvested from the site deviated the most. The histologic difference of the septal cartilage by hematoxylineosin staining under a light microscope was performed. RESULTS: The chondrocyte densities were significantly higher in the convex side than in the concave side of the septal cartilage in Group I, II, III. Especially, the increased chondrocyte ratio (convex/concave) were more evident in the septal cartilage traumatized at the age of 10 to 15 years, and the cartilage plate was thicker than the other groups (p<0.001). Also, dystrophic changes of the chondrocytes as representing the chondrocyte differentiation and chondroblast ratio (convex/concave) were significantly higher in the group II than in the other groups (p<0.005). CONCLUSION: This study demonstrated that age dependent changes in septal cartilage with nasal trauma showed distinctive histologic characteristics. We suggest that these observations will help determine surgical treatment modality for cases of nasal septal deviations with and without trauma.
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Adult , Humans , Cartilage , ChondrocytesABSTRACT
Although augmentation rhinoplasty with silicone implant was once the mainstream technique, more complex rhinoplasty procedures that focus on reshaping the nasal tip and columella are required to meet the customers' demands. After columellar control strut or septal extension graft have been introduced for the correction of the nasal tip and columella, the results of augmentation rhinoplasties were very good. But, the problem is the dimension of the septal cartilage which is used for the graft material. So, we dissected a total of 10 cadavers. The anterior-posterior dimension and the cephalic-caudal dimension of the septal cartilage were measured as if it were a rectangular shape. With using a 10 mm L-shaped strut, a septal cartilage was measured, too. As the results, we found that the anterior-posterior dimension of the septal cartilage was 22.1 mm on average, and the cephalic-caudal dimension was 28.0 mm on average. The average size of the septal cartilage was 627.2 mm2. With using a 10 mm L-shaped strut, the possible size of the graft was 226.2 mm2 with an average anterior-posterior dimension of 12.1 mm and an average cephalic-caudal dimension of 18.0 mm. This report will be beneficial when the surgeon performs the various rhinoplasty techniques using the septal cartilage.
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Cadaver , Cartilage , Rhinoplasty , Silicones , TransplantsABSTRACT
The nose is the most 3-dimensional structure located on the central area of the face. Rhinoplasty using autogenous tissues and alloplastic materials has been performed for augmentation of nasal tip and dorsum in Asia. For batten graft, spreader graft, columellar strut and/or tip plasty, autogenous tissue especially nasal septal cartilage is very useful. Sometimes surgeon is faced to the situation when usable septal cartilage is too small so other tissues or materials are needed during the operation. The purpose of this study is that we should predict the amount of obtainable septal cartilage by variant measurements of the nose and investigated relationship each other. From December 2002 to February 2004, on the 31 cases that operated rhinoplasty using septal cartilage, we took variable measurements such as nasal length, tip width, nasal basal width, nasal height, columellar width and length of nostril long axis preoperatively. Then we investigated the relationship with amount of actual harvested septal cartilage. As a result, the nasal length was the most correlated with cartilage amount statistically and tip and base width were correlated as well. In this study we concluded that nasal length was the most indicating parameter to predict amount of septal cartilage.
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Asia , Axis, Cervical Vertebra , Cartilage , Nose , Rhinoplasty , TransplantsABSTRACT
The retraction of the upper eyelid is associated with thyroid dysfunction, facial palsy, trauma, and overcorrection of ptosis and also occurs iatrogenically after eyelid or orbital surgery. In this condition, corneal exposure leads to discomfort, epiphora, and corneal irritation. Moreover increased showing of sclera above corneal limbus is considered one of cosmetic defect. Treatment modalities may be either medical or surgical. The medical treatments consists of control of thyroid dysfunction, steroid, sympatholytics. Many authors described surgical correction; recession of levator palpebral muscle or M ller muscle and graft matrix. The difficulties in surgical treatment consist of unpredictability of levator-M ller muscle manipulation, and healing of grafted material. Two patients have been operated with using of septal cartilage-mucosa composite graft. nasal septal cartilage-mucosa composite graft is autologous, firm, thin and harvested easily. The result was satisfactory functionally and aesthetically.
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Humans , Eyelids , Facial Paralysis , Lacrimal Apparatus Diseases , Limbus Corneae , Orbit , Sclera , Sympatholytics , Thyroid Gland , TransplantsABSTRACT
Objective: To study the relationship between the congenital cleft palate and development of the nasal capsule and nasal septum. Methods: 30 pairs of NMIR fetal mouse at the embryo age of 16～17 days were used.In each pair there was one euploid mouse without cleft palate and one trisomy 18 mouse with cleft palate.Sixty maxillae were precisely orientated in the coronal plane and serially sectioned at 7 ?m thickness. With the aid of computer imaging analysis system the width,height and area of the nasal capsule, nasal septum and cartilage of nasal septum were measured and compared quantitatively between the cleft group and non-cleft group. Results: The values of height and area of the nasal capsule, nasal septum and cartilage of nasal septum in cleft foetuses were smaller than those in non-cleft foetuses (P
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BACKGROUND AND OBJECTIVES: Overcorrection is defined as obvious deviation of the septum to the opposite direction after septoplasty and it is not infrequently developed in young patients. We investigated the rate of its incidence, especially in relation to age. MATERIALS AND METHODS: We retrospectively studied 1,124 patients undergoing septoplasty operation for septal deviation between 1994 and 1999. The operations and postoperative observation were performed by a single surgeon. We reviewed the medical records for age, sex, symptoms, combined operations, direction of deviation before and after septoplasty. RESULTS: Out of 1,124 patients, 22 (2.0%) had their septum overcorrected after septoplasty and 21 (95%) complained of nasal obstruction of the newly deviated side. The incidence of overcorrection was 7.3% (16/218) in teens, 1.7% (5/294) in twenties, 0.4% (1/250) in thirties, and 0% in older ages. The incidence in teens and early twenties was 5%. Patients of teenagers revealed significantly higher incidence as compared to other age groups (p<0.05). CONCLUSION: Overcorrected septum as a complication of septoplasty develops at the incidence rate of 5% in patients of teens and early twenties. Authors suggest that the depth of cross-hatching incision on the cartilage should be superficial or half-thickness to avoid overcorrection in young patients. And the possibility of overcorrection or revision septoplasty should be informed preoperatively.
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Adolescent , Humans , Cartilage , Incidence , Medical Records , Nasal Obstruction , Retrospective StudiesABSTRACT
There are several characteristics of the nasal tip of Orientals. The skin is thick with severe tension and a bulbous nasal tip, the nostrils are wide, and the projection of the nose is limited due to a poorly developed alar cartilage with a short columella. Until now, in order to well outline the nasal tip and project the nose, the alar cartilage was realigned, the domes of the cartilage sutured together, silicone or cartilage was used to improve the appearance of the tip. However, it was difficult to achieve satisfactory results in Orientals due to a short columella and a acute nasolabial angle. From May 1998 to March 2000, the authors attempted to realign the alar cartilage with an open rhinoplasty approach and used the septal cartilage to project the nasal tip and lengthen the columella by designing the increased nasolabial angle in 20 cases. The cartilage was then inserted in the alar cartilage and fixed on the anterior nasal spine. The results, considered satisfactory in all patients without any complications, are as follows: 1. The changes of nasolabial angles were from 88.7 degrees to 95.3 degrees, 2. The average increase in columellar height was 3.5 mm, 3. The average decrease of the alar width was 3.0 mm, 4. The changes of the angle between the long axis of the external naris was from 92.2 degrees to 71.5 degrees. This procedure is an effective method in improving nasolabial angle and columella length.