The external rhinoplasty approach for rhinologic surgery.

The technique of external rhinoplasty has enjoyed a renaissance over the last ten years, primarily for cosmetic and functional septorhinoplasty, and we have found this to be an effective method for nasal reconstruction. Moreover, we have recognized the versatility of this approach for a variety of rhinologic problems and have utilized it for transsphenoidal hypophysectomy, sphenoidotomy, unilateral choanal atresia, septal perforation, nasal valvuloplasty and rhinophyma. We describe our technique and the rationale for employing it. We conclude that the enhanced exposure provided by the cutaneous decortication of the nose facilitates surgery of both the soft tissues and the supportive architecture of the nose.

External rhinoplasty approach to unusual rhinologic procedures.

The technique of external rhinoplasty has enjoyed a renaissance over the last ten years primarily for cosmetic and functional septorhinoplasty. The versatility of this approach for a variety of rhinologic problems is exemplified by the previous case studies. More specifically, it affords unparalleled exposure of the nasal architecture and for the repair of septal perforations and nasal obstruction secondary to nasal valve deficiency. It may also aid the surgeon in defining the level of cartilage and skin thickness in the excision of rhinophyma. Beyond the unchallenged advantage of improved exposure that the external rhinoplasty approach affords, the surgeon is able to use both hands (as one is not occupied with the nasal speculum) and to view the procedure with binocular vision and greater depth perception. The teaching advantages are obvious. The method is not difficult, it may be done under local anesthesia and it entails no additional risk to the patient.