Resultados de la técnica septum bisagra en desviación de la punta nasal / Septum hinge technique outcomes in nasal tip deviation

Introducción: La desviación de la punta nasal suele producir alteración estética y funcional nasal. Generalmente, asocia alteraciones morfológicas de los cartílagos alares, además de dismorfia del cartílago septal. Objetivo: Presentar una técnica quirúrgica alternativa para el tratamiento de la laterorrinia en tercio inferior nasal y sus resultados. Material y Método: Se trataron 27 pacientes con una laterorrinia en punta nasal con la técnica del septum bisagra, incluyendo la colocación de uno o dos injertos de expansión. Describimos el protocolo de anamnesis y exploración que seguimos en estos pacientes y la descripción detallada de la técnica quirúrgica. Resultados: En 19 pacientes se utilizó un injerto de expansión unilateral para completar la técnica y en ocho de forma bilateral. Se obtuvo una puntuación media en la escala visual analógica (EVA) de ventilación de 8,3, con una mejoría de seis puntos, y en la EVA de aspecto estético de 8,1, mejorando en 4,6 puntos. Conclusión: la utilización de la técnica del septum bisagra es beneficiosa para el tratamiento de la desviación de la punta nasal, tanto a nivel funcional como estético. Presenta ciertas diferencias frente a otras técnicas descritas. La indicación se debe adecuar a cada paciente de manera individualizada.

Introduction: Deviation of nasal tip usually produces aesthetic disturbance and nasal ventilation decrease. It is usually associated with alar cartilages morphologic disturbances and dysmorphia of the septal cartilage. Aim: To present an alternative surgical technique for treating laterorrhinia in the nasal inferior third and its outcomes. Material and Method: 27 patients with nasal tip laterorrhinia were treated with the hinge septum technique, including the placement of one or two spreader grafts. We describe the anamnesis and exploration protocol that we carried out in these patients and a detailed description of the surgical procedure. Results: Unilateral spreader graft was used in 19 patients to complete the technique, and bilateral spreader graft was used in eight. The average score in visual analogue scale (VAS) related to nasal flow was 8.3, which means an improvement of six points, and in VAS related to aesthetic appearance the score was 8.1, improving 4.6 points. Conclusion: The use of the hinge septum technique is useful to treat the deviation of the nasal tip in a functional and aesthetic way. There are several differences compared to other described techniques. The indication has to be suitable for each patient individually.

Understanding the use of polycaprolactone in East Asian Structural Rhinoplasty: Questions and Answers

@#Surgery as an art in rhinoplasty involves grafting techniques wherein materials (usually autologous) are taken from the septum and supplemented by conchal cartilage. However, not all noses have adequate cartilage material. The quest for materials as possible replacement for human tissue have led to invention of synthetic (e.g. silicone, e-PTFE, porous polyethelene) and non-synthetic products (e.g. processed homograft and xenograft). In this era of advanced medical science, tissue engineering has started the use polycaprolactone (PCL) as a template and scaffold for tissue growth. Because of this characteristic feature, PCL as a mesh has a significant role in structural rhinoplasty.

Lengthening the short nose with bilateral septal spreader graft and columellar strut / 中华医学美学美容杂志

Objective To investigate a safe and effective method of lengthening the short nose.Methods Thirty-nine cases of short nose were corrected by the bilateral septal spreader graft and columellar strut using autologous cartilage,combined with expanded polytetrafluoroethylene (e-PTFE)to reconstruct the supporting structures to improve the forward and upward strength of the nasal tip in order to increase the nasal length and to correct the over rotation of nasal tip.The shield and cap grafts were also used for the patients whose nasal tip were too low with vertical dome division technique.Results All the patients showed preserved nasal length after surgery with well-proportioned nasal features and the nasal lip angles were normal.There was no evidence of postoperative nasal shortening.No operative or postoperative complications were observed by follow-up for 6 months to 1 year,except for 2 cases with graft cartilage being apparent on nasal tip.All the patients were satisfied with the surgical results achieved.Conclusions It is necessary to provide powerful forward and upward strength to lengthen nose and correct the over rotation of nasal tip effectively and safely.The application of bilateral septal spreader graft and columellar strut using autologous cartilage and combined with e-PTFE represents a valuable tool for the short nose and proper cartilage grafts of nasal tip can improve the height of the nasal tip and further correct the over rotation of the nasal tip.