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External valve rhinoplasty

Oren Friedman, Erdinc Cekic, Ceren Gunel
Understanding nasal anatomy and physiology are the most important points for successful functional rhinoplasty. Anatomic structures playing major roles in nasal breathing functions include the septum, and internal and external nasal valves, so physical examination of these regions is essential. Planning for functional rhinoplasty involves the identification of the sites of nasal airway obstruction or old trauma, and addressing those regions during the operation with a number of different techniques that have been described...
May 2017: Facial Plastic Surgery Clinics of North America
Giulia Amodeo, Domenico Scopelliti
The nasal valve area is the functional area that allows airflow regulation. It could be divided in an internal area and an external one, basing on the anatomical landmarks. Many conditions can damage these areas with a consequently nasal obstruction, more often in particular extended rhinoplasty and sequels of facial trauma. To restore this area many techniques were advocated during the last decades.In this article the authors investigate on valve areas deficiency in sequel of rhinoplasty proposing a structural approach through alar batten grafts to correct internal-external nasal valves collapse...
June 2017: Journal of Craniofacial Surgery
Jennifer L Goodrich, B J F Wong
The alar lobule, alar margin, and soft triangle facet are receiving more attention in the literature as critical elements to address both preoperatively and during rhinoplasty. We have found that the use of the articulated alar rim graft (AARG) corrects deficiencies in these areas as well as provides mechanical stability to the external valve. In this article, we describe indications for AARG, describe in detail the procedure for AARG placement, and highlight the transformation AARGs can achieve in two illustrated case studies...
December 2016: Facial Plastic Surgery: FPS
Reginaldo de Oliveira Silva Filho, Victor Diniz de Pochat
BACKGROUND: Lateral crural strut graft has been used in rhinoplasty to correct deformities such as bulbous nasal tip, lateral crus malposition, alar retraction, collapsed external valve, lateral crus concavity, and alar deformity after domal suture. Despite its widespread use, the lateral crural strut graft has not been the subject of studies that show its benefits objectively and statistically. OBJECTIVES: To assess nasal anatomical variations in cadavers that underwent rhinoplasty using the lateral crural strut graft, considering the clinical applications of this graft...
September 2016: Aesthetic Surgery Journal
Michelle Lee, Bahman Guyuron
BACKGROUND: The authors examined the dynamics of the subdomal graft and its frequency of use in primary and secondary rhinoplasty in detail. METHODS: One hundred consecutive primary and 100 consecutive secondary rhinoplasty patients with at least 1 year of follow-up were reviewed retrospectively. The nose sheet containing a detailed intraoperative recording of all rhinoplasty maneuvers was reviewed to analyze the frequency of subdomal graft use. Intraoperative observations of the effects of the subdomal graft on the nasal tip and the surrounding structures were recorded...
June 2016: Plastic and Reconstructive Surgery
Ali Ebrahimi, Amin Shams
Nostril stenosis (narrowing of the nasal inlet) is an uncommon deformity which results in aesthetic and breathing discomfort in patients. The literature review shows that trauma, infection, iatrogenic insults and congenital lesions are major causes of stenosis. Nowadays, rhinoplasty is one of most popular aesthetic surgeries which may have complications such as bleeding, swelling, bruising, asymmetry, obstruction of nasal airways. We present a 30-year-old female patient, who complained about breathing and aesthetic difficulties due to external nasal valve obstruction and nasal deformity...
September 2015: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Grant S Hamilton
Dysfunction of the external nasal valve affects both the form and function of the nose. Successful treatment of these problems is dependent on proper analysis and diagnosis of the aberrant anatomy. Cephalic malpositioning of the lateral crura has been described for nearly 30 years. Repositioning of the lateral crura in a more caudal orientation with lateral crural strut grafts will correct aesthetic abnormalities and reinforce the external nasal valve. Sagittal malpositioning has been more recently described and also has deleterious effects on both the shape of the nasal tip and breathing...
February 2016: Facial Plastic Surgery: FPS
Ankona Ghosh, Oren Friedman
The key to a successful septorhinoplasty includes an understanding of nasal anatomy and physiology. This allows the surgeon the ability to properly address both form and function during the operation. History and physical examination are paramount in diagnosing and subsequently treating the epicenter of obstruction, which is commonly found among the internal and external nasal valve, the septum, or the turbinates. Treatment of each of these areas is nuanced and multiple approaches are discussed to provide an understanding of the current surgical techniques that allow for excellent functional and cosmetic rhinoplasty results...
January 2016: Clinics in Plastic Surgery
Kyle J Chambers, Kate A Horstkotte, Kerry Shanley, Robin W Lindsay
IMPORTANCE: Patients with a septal deviation and concerns about nasal obstruction often undergo septoplasty to improve nasal airflow. Following primary septoplasty, however, some patients have persistent symptoms due to nasal valve dysfunction and may require nasal valve surgery. OBJECTIVES: To evaluate the change in disease-specific quality of life for patients who undergo nasal valve correction after failed septoplasty using the Nasal Obstruction Symptom Evaluation (NOSE) survey and to determine whether identifiable anatomical risk factors are more common in patients with a history of failed septoplasty...
September 2015: JAMA Facial Plastic Surgery
Henry P Barham, Anna Knisely, Jenna Christensen, Raymond Sacks, George N Marcells, Richard J Harvey
IMPORTANCE: External nasal valve dysfunction (EVD) is a common cause of nasal obstruction. OBJECTIVE: To evaluate costal cartilage lateral crural strut grafts vs cephalic crural turn-in to support the weak lateral crus in patients with EVD. DESIGN, SETTING, AND PARTICIPANTS: In this prospective cohort study, patients with clinically diagnosed EVD were assessed at the Tertiary Rhinologic Center and underwent a costal cartilage underlay graft to the lateral crus or a cephalic turn-in cruralplasty...
September 2015: JAMA Facial Plastic Surgery
Sam P Most
No abstract text is available yet for this article.
September 2015: JAMA Facial Plastic Surgery
Cemal Alper Kemaloğlu, Mehmet Altıparmak
BACKGROUND: Alar cartilage malposition is a common anatomic variation in which the axis of the lateral crus lies cephalically and may be parallel to the cephalic septum. Malposition of the lateral crura may produce inward collapse of the alae that is observable on deep inspiration. OBJECTIVES: The authors performed the alar rim flap technique to treat patients with alar malposition and assessed functional and aesthetic outcomes. METHODS: Twelve patients who underwent primary open rhinoplasty with the alar rim flap technique were evaluated in a prospective study...
November 2015: Aesthetic Surgery Journal
David Chan, Taha Z Shipchandler
PURPOSE OF REVIEW: Functional rhinoplasty is a term that is commonly used to describe any technique used to address nasal obstruction in the nasal valve region. The cause of nasal valve collapse differs based on the site. Internal valve collapse may be idiopathic or associated with previous rhinoplasty, trauma, or weakened cartilage in older patients. External valve collapse is usually idiopathic and less likely to be associated with previous surgery. Various techniques have been developed over time, and the data in support of functional rhinoplasty continue to increase...
August 2015: Current Opinion in Otolaryngology & Head and Neck Surgery
James B Collins, Marcin Czerwinski
BACKGROUND: Although excellent techniques for reconstruction of nasal cover and support have been described, reconstruction of large nasal lining defects remains a challenge. Currently available methods have several shortcomings including limited size, airway obstruction, need for multiple procedures, and creation of septal fistulae. METHODS: We present 2 cases of nasal lining reconstruction for the lower and mid nasal vaults using a contralateral dorsally based septal mucoperichondrial page flap transposed dorsal to nasal septum and superficial to the ipsilateral upper lateral cartilage...
June 2015: Journal of Craniofacial Surgery
B Bohluli, P Varedi, R Kahali, S C Bagheri
Many methods and techniques have been proposed for the assessment of the nasal valve, most requiring special equipment. Furthermore the main focus has been on the internal valve, while the role of the external nasal valve (ENV) has usually been underestimated. An index to assess ENV is presented herein. Two photographs of the basal view of the nose are taken, one in the resting position and the other after deep inspiration. These two life-size views are used to calculate the External Nasal Valve Efficacy Index (ENVE Index)...
October 2015: International Journal of Oral and Maxillofacial Surgery
Tom Palesy, Eleanor Pratt, Nadine Mrad, George N Marcells, Richard J Harvey
IMPORTANCE: External nasal valve dysfunction (ENVD) is a common cause of nasal obstruction. Although many techniques are described to help correct ENVD, evidence of the objective changes in the airway achieved by these interventions is mainly unknown. OBJECTIVE: To document the airway changes in patients with ENVD by comparing subjective and objective measures obtained before and after rhinoplasty. DESIGN, SETTING, AND PARTICIPANTS: Prospective case series with validated subjective and objective outcomes at a tertiary rhinologic center in Sydney, Australia...
March 2015: JAMA Facial Plastic Surgery
Daniel G Moina, Gabriel Moina, Alberto Rancati
BACKGROUND: Severe lateral crura concavity (LCC) can lead to an important deformity of the nasal tip and to external nasal valve insufficiency. The lower lateral crural reverse plasty represents a valuable technique for the correction of severe LCC, but often requires additional cartilage to gain more alar rim support. METHODS: We describe a modified version of the reverse plasty, in which a polydioxanone plate is sutured as a strut at the dome junction to increase alar rim support...
December 2014: Aesthetic Plastic Surgery
Mehtap Karameşe, Osman Akdağ, Ahmet Akatekin, Tugba Gün Koplay, Mustafa Koplay, Zekeriya Tosun
External nasal deviation is caused primarily by severely a deformed septum. The nose functions as a whole composed of the septum, valve systems, and mucosal structures. Patients with severely deviated septums also have deformed nasal valve systems. Extracorporeal septoplasty is advocated for an extremely deviated nasal septum. Nasal valve dysfunctions can be resolved successfully with spreader grafts. Application of extracorporeal septoplasty in combination with spreader grafts in patients with nasal valve dysfunction not only enables nasal respiration but also supports aesthetic appearance...
January 2016: Annals of Plastic Surgery
Elaine Fung, Paul Hong, Corey Moore, S Mark Taylor
Objective. To assess the outcomes of functional rhinoplasty for nasal valve incompetence and to evaluate an in-office test used to select appropriate surgical techniques. Methods. Patients with nasal obstruction due to nasal valve incompetence were enrolled. The modified Cottle maneuver was used to assess the internal and external nasal valves to help select the appropriate surgical method. The rhinoplasty outcomes evaluation (ROE) form and a 10-point visual analog scale (VAS) of nasal breathing were used to compare preoperative and postoperative symptoms...
2014: Plastic Surgery International
Gökhan Temiz, Nebil Yeşiloğlu, Murat Sarici, Gaye Taylan Filinte
Congenital nasal abnormalities are very rare in the literature. There are 3 reported cases of isolated partial lower lateral cartilage defects. In this article, we report the case of a patient with congenital complete absence of the lower lateral cartilage. The patient had severe external nasal valve dysfunction and a concavity of the alar vault, even in the resting position. The defect was reconstructed using resected and reshaped nasal dorsal hump material. At the end of a 12-month follow-up period, the patient was satisfied with the functional and aesthetic results of the operation...
September 2014: Journal of Craniofacial Surgery
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