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.

Rhinoplasty via Extended Marginal Incision / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Traditional open rhinoplasty produces a scar on the columella. In previous survey using questi-onnaires, 77 percent of subjects refused to accept a small scar in the columella region, even when they were told that the scar would disappear in time. To avoid such a scar, rhinoplasty was performed without transcolumellar incision. MATERIALS AND METHODS: Skin incision was extended from a traditional marginal incision to the footplate of the medial crus. Rhinoplasty was done in 99 patients. RESULTS: The columella artery was not damaged. Necrosis, notching, and scar did not occur on the columella. Because the skin continuity was preserved, it was easier to watch and correct any or all abnormalities of the external nasal contour during operation than traditional open rhinoplasty. It was possible to accurately operate both the tip and the dorsum under direct vision like traditional open rhinoplasty. CONCLUSION: Approach via extended marginal incision is a very useful method in operating both the nasal tip and the nasal dorsum.

Evaluation of Augmentation Rhinoplasty and Tip Surgery Using Cartilage Autograft by Standardized Lateral View of Photodocumentation / 대한이비인후과학회지

BACKGROUND AND OBJECTIVE: Nasal tip projection and dorsal realignement are important defining features of nasal profile. Recently, the use of rhinoplasty has increased by rhinologic surgeons and good cosmetic results have been reported. But, sufficient analysis of postoperative results is not presented in augmentation rhinoplasty. We aimed to evaluate the augmentation rhinoplasty using pre- and postoperative lateral view under similar conditions. MATERIALS AND METHODS: We performed 22 cases of augmentation rhinoplasty with cartilage auteograft (8 males and 14 females, aged 21 to 53 years) between September 1997 and August 1998. Using lateral view, pre- and postoperative nasofrontal, nasofacial, nasolabial, nasal tip rotational angle, and height of nasion, depth of the nasion, tip projection, tip angle were analysed. RESULTS: The increment of nasofrontal angle was 3.3degreesin males and 3.8degrees in females. The increment of height of the nasion was 1.4 mm in males and 2.1 mm in females, and the increment of tip projection was 1.3 mm in males and 1.7 mm in females, and the increment of tip angle was 1.6degreesin males and 2.1degreesin females. The increment of nasofacial angle was 2.9degrees in males and 3.9degrees in females, and the increment of nasolabial angle was 0degrees in males and 1.6degreesin females. The increment of nasal tip rotational angle was 0.2degrees in males and 0.7degreesin females, respectively. CONCLUSION: We achieved good cosmetic results by cartilage autograft and hoped to increase the efficacy of augmentation rhinoplasty in future, based on this study.