Transcutaneous Columellar Strut for Correcting Caudal Nasal Septal Deviation.

Correction of caudal septal deviation is a challenging issue because of its significant role in tip support mechanisms. Some interventions especially aggressive resection of caudal septum to correct deviation, may compromise external nasal valve, tip ptosis and persistence of nasal obstruction. Many surgical techniques have been suggested to correct this type of nasal septal deviation. This study presents a technique to correct caudal septal deviation without weakening of tip support mechanisms. To evaluate the efficacy of insertion of a transcutaneous columellar strut during correction of caudal septal deviation. The study was performed in patients complaining from nasal obstruction with caudal septal deviation. After intranasal incision and elevation of mucoperichondrial flap, Caudal septum released from anterior nasal spine (ANS) and a band of cartilage removed from inferior and caudal part of septum and septum again fixed to ANS. Through a vertical transcutaneous incision, a cartilaginous strut is placed in columella, between medial crurae. Preoperative and postoperative NOSE score determined and photographs were taken. In 14 patients we performed this technique, the postoperative NOSE score showed significant improvement, (p = 0.001). Nasal breathing improved in all patients without any complication or tip ptosis or worsening of nasal appearance. This septoplasty technique along with placement of transcolumellar strut, is an easy, efficient and complication free method for simultaneously correction of caudal deviation of nasal septum, reinforcing external nasal valve and prevents tip ptosis.

Co-presentation of Tapia's syndrome and pressure alopecia--A rare event after septorhinoplasty: A case report and literature review.

Tapia's syndrome and pressure alopecia (PA) are two rare but distressing complications associated with orotracheal intubation and positioning of the head during surgery. To our knowledge, simultaneous occurrence of both complications after surgery has not been previously reported. To avoid these disturbing complications, the mechanisms of the injury and the preventive measures should be recognized by anesthesiologists and surgeons. We herein present the case of Tapia's syndrome together with PA following open septorhinoplasty under uncomplicated endotracheal general anesthesia in a 27-year-old man. We review other case reports and discuss the potential underlying mechanisms of injury.

A familial occurrence of lip anomaly.

Lip pits are among the rarest congenital deformities recorded. Initially reported in 1845, its familial occurrence has been reported just once. These developmental anomalies occur either as an isolated defect or in association with other developmental deformities, including cleft lip, cleft palate, or both. They may be located at the commissures of the lips or at the midline of the lower lip. Lip pits are often inherited as an autosomal dominant trait with variable penetrance. Our report of a family in which all of the 3 children (2 girls and 1 boy) and their father were involved is in concert with the latter statement.