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Plastic and Reconstructive Surgery Jul 2021Secondary cleft rhinoplasty presents some of the most challenging cases of both cosmetic and functional nasal deformities. Understanding the anatomy and growth... (Review)
Review
BACKGROUND
Secondary cleft rhinoplasty presents some of the most challenging cases of both cosmetic and functional nasal deformities. Understanding the anatomy and growth abnormality seen with the cleft nasal deformity helps to tailor surgical management. This article seeks to expand on the application of current concepts in secondary rhinoplasty for unilateral cleft lip nasal deformity.
METHODS
The authors review nasal analysis in the cleft rhinoplasty patient and provide the surgical management for each aspect in the secondary cleft rhinoplasty.
RESULTS
The secondary rhinoplasty was divided into seven areas: piriform hypoplasia, septal reconstruction, dorsal reshaping, tip reshaping, tip projection, alar reshaping, and alar repositioning. Surgical management for each is provided.
CONCLUSION
Secondary cleft rhinoplasty requires an understanding of the structural dysmorphology, and the use of cosmetic, functional, and secondary rhinoplasty techniques for its successful management.
Topics: Cleft Lip; Esthetics; Humans; Nasal Cartilages; Nasal Septum; Reoperation; Rhinoplasty; Treatment Outcome
PubMed: 34076624
DOI: 10.1097/PRS.0000000000008124 -
Body Image Sep 2016Our aim was to systematically review the prevalence of body dysmorphic disorder (BDD) in a variety of settings. Weighted prevalence estimate and 95% confidence intervals... (Review)
Review
Our aim was to systematically review the prevalence of body dysmorphic disorder (BDD) in a variety of settings. Weighted prevalence estimate and 95% confidence intervals in each study were calculated. The weighted prevalence of BDD in adults in the community was estimated to be 1.9%; in adolescents 2.2%; in student populations 3.3%; in adult psychiatric inpatients 7.4%; in adolescent psychiatric inpatients 7.4%; in adult psychiatric outpatients 5.8%; in general cosmetic surgery 13.2%; in rhinoplasty surgery 20.1%; in orthognathic surgery 11.2%; in orthodontics/cosmetic dentistry settings 5.2%; in dermatology outpatients 11.3%; in cosmetic dermatology outpatients 9.2%; and in acne dermatology clinics 11.1%. Women outnumbered men in the majority of settings but not in cosmetic or dermatological settings. BDD is common in some psychiatric and cosmetic settings but is poorly identified.
Topics: Adolescent; Adult; Body Dysmorphic Disorders; Body Image; Cross-Cultural Comparison; Cross-Sectional Studies; Dermatology; Female; Humans; Male; Mass Screening; Medicine; Middle Aged; Referral and Consultation; Rhinoplasty; Surgery, Plastic; Young Adult
PubMed: 27498379
DOI: 10.1016/j.bodyim.2016.07.003 -
Brazilian Journal of Otorhinolaryngology 2017Untreated septal and/or nasal pyramid deviation in children should be corrected as soon as possible, because they can result in esthetic or functional problems years...
INTRODUCTION
Untreated septal and/or nasal pyramid deviation in children should be corrected as soon as possible, because they can result in esthetic or functional problems years later.
OBJECTIVE
To report the surgical experience in treating children with nasal septum and/or nasal pyramid deviation.
METHODS
Review of medical records of 202 children, 124 (61.4%) males and 78 (38.6%) females, between 4 and 16 years of age (M=11 years) who underwent rhinoplasty and/or septoplasty in a Pediatric Otolaryngology Service of the Dept. of Otolaryngology and Head and Neck Surgery between January 1994 and January 2010.
RESULTS
Septoplasty performed in 157 cases (77.7%); rhinoseptoplasty in 23 cases (11.4%), and rhinoplasty in 22 cases (10.9%).
CONCLUSION
Nasal changes should be corrected in children, in order to provide harmonious growth, and prevent severe sequelae found in mouth breathers.
Topics: Adolescent; Child; Child, Preschool; Female; Humans; Male; Nasal Septum; Rhinoplasty
PubMed: 27339699
DOI: 10.1016/j.bjorl.2016.04.019 -
California Medicine Jul 1957Rhinoplasty is safe, relatively painless and, if patients are carefully selected, quite successful. Psychological and personal benefits amply justify the procedure....
Rhinoplasty is safe, relatively painless and, if patients are carefully selected, quite successful. Psychological and personal benefits amply justify the procedure. Frequent indications are feelings of social rejection or ridicule and racial discrimination. Psychoneurotic patients with severe complexes, however, are poor subjects for rhinoplasty and should not be operated upon. It is doubtful that rhinoplasty grossly changes the physiologic integrity of the nose. Psychological trauma to the patient during hospitalization is to be avoided, sedation properly gauged for each patient, and complete block anesthesia used to preserve the cough reflex. The operation is brief and a small splint is worn for a few days. Complications are rare.
Topics: Humans; Nose; Rhinoplasty
PubMed: 13446739
DOI: No ID Found -
Facial Plastic Surgery : FPS Dec 2023A wide variety of grafting materials and techniques can be used to create functional and aesthetic changes in rhinoplasty. Choosing the optimal grafting approach is... (Review)
Review
A wide variety of grafting materials and techniques can be used to create functional and aesthetic changes in rhinoplasty. Choosing the optimal grafting approach is critical to achieving an optimal patient outcome. We present a review of autografts, allografts, and alloplasts used in primary and revision rhinoplasty and discuss factors that impact graft choice. Autologous grafts serve as the pillar for grafting material in rhinoplasty given their reliable long-term outcomes, low rates of infection, resorption, and extrusion, and ability to provide structural scaffolding as well as contour. Cadaveric allografts can be utilized as a source of grafting material in certain clinical scenarios including revision rhinoplasty and have been shown to be equally safe and effective as autologous grafts while avoiding donor-site morbidity. Alloplasts can prove useful in rhinoplasty in cases of iatrogenic nasal deformities or revision cases. Careful consideration of clinical scenario, patient factors, and outcome goals is necessary to choose the appropriate grafting approach to address functional and cosmetic outcomes.
Topics: Humans; Rhinoplasty; Esthetics, Dental; Transplantation, Autologous; Autografts; Reoperation; Retrospective Studies
PubMed: 37348541
DOI: 10.1055/a-2116-4566 -
European Review For Medical and... Mar 2023The aim of this paper is to investigate the efficacy of filler applications which were evaluated in terms of nasal deformity and quality of life of the patients, and to...
OBJECTIVE
The aim of this paper is to investigate the efficacy of filler applications which were evaluated in terms of nasal deformity and quality of life of the patients, and to review the fillers around the nose.
PATIENTS AND METHODS
Forty patients who underwent filler application were included into the study and were divided into Group 1 (Deep Radix), Group 2 (Minor irregularities due to rhinoplasty), Group 3 (Shallow dorsum) and Group 4 (Dorsal irregularity). There were 10 patients in each of the groups. In all groups, nasal deformity score was evaluated with a 1 to 5 scale as following: 1- No deformity, 2- Hardly visible deformity, 3- Visible deformity, 4- Moderate deformity, 5- Apparent deformity. Quality of life was evaluated by a 1 to 10 scale, 1 showing very low and 10 showing very high.
RESULTS
Our results showed that there were statistically significant improvements (decreased) in nasal deformity evaluation scores after the procedure compared to the before the procedure scores in Group 1 (Deep Radix), Group 3 (Shallow dorsum) and Group 4 (Dorsal irregularity) (p<0.05) However in Group 2 (Minor irregularities due to rhinoplasty), there were no significant differences between the nasal deformity evaluation scores after and before the procedure (p>0.05). For nasal deformity evaluation after the procedure, Group 1 (Deep Radix), Group 3 (Shallow dorsum) and Group 4 (Dorsal irregularity) scores were significantly lower (better) than Group 2 (Minor irregularities due to rhinoplasty) scores (padjusted <0.0125). In all four groups (Deep Radix, Minor irregularities due to rhinoplasty, Shallow dorsum, Dorsal irregularity), quality of life scores were significantly improved (increased) after the procedure compared to before the procedure (p<0.05). For Quality of life (VAS) before the procedure, Group 3 (Shallow dorsum) scores were significantly higher (improved, increased) than Group 1 (Deep Radix) and Group 4 (Dorsal irregularity) (padjusted <0.0125).
CONCLUSIONS
Filler applications improved (decreased) nasal deformity evaluation scores and improved (increased) quality of life scores. Fillers can be applied for deep radix, minor irregularities due to rhinoplasty, shallow dorsum and dorsal irregularity. It is essential to choose carefully appropriate materials and procedures for patients to obtain optimum results.
Topics: Humans; Quality of Life; Nose; Rhinoplasty
PubMed: 36971217
DOI: 10.26355/eurrev_202303_31697 -
European Annals of Otorhinolaryngology,... May 2021Septorhinoplasty by disarticulation is an esthetic and functional solution for naturally occuring nasal pyramid dysmorphia, releasing the anatomic traces of...
Septorhinoplasty by disarticulation is an esthetic and functional solution for naturally occuring nasal pyramid dysmorphia, releasing the anatomic traces of growth-related stresses. Disarticulating the septolateral cartilage from its bony framework via a closed approach to the septal pocket is associated to Rethi's external approach in order to disarticulate the fibrocartilaginous nasal dorsum, while conserving its integrity, under the bony dorsum. The bony pyramid is then disarticulated down to the nasion, after resecting any bone hump, by 2 paramedian and 2 low lateral osteotomies in the basal groove. The lateral sides of the bony pyramid are then fractured at their posterior edges by percutaneous pinching to close the open roof and realign them along the midline. The septolateral cartilage, reduced as necessary at the inferior and anterior edges, is thereafter repositioned on the premaxillary bone. Traction on its anterior edge restores rectilinear frontal and lateral tension in the fibrocartilaginous dorsum, fully conserved from its attachment to the nasion. This technique corrects any septal deformity and restores frontal and lateral dorsum straightness.
Topics: Cartilage; Disarticulation; Esthetics; Humans; Nasal Septum; Nose; Rhinoplasty
PubMed: 32718850
DOI: 10.1016/j.anorl.2020.06.018 -
Ugeskrift For Laeger Sep 2023Injuries to the cartilaginous structures of the nose can arise after minor trauma and without a concomitant nasal fracture. They are diagnosed with a thorough clinical... (Review)
Review
Injuries to the cartilaginous structures of the nose can arise after minor trauma and without a concomitant nasal fracture. They are diagnosed with a thorough clinical examination and can, if not diagnosed and treated in the acute phase, result in nasal/septal deformation, saddle nose or abscess formation with subsequent intracranial spreading of the infection. Even with proper treatment in the acute phase, the cartilage often heals with deviation. This can result in functional and cosmetic problems which may require later reconstructive surgery, as argued in this review.
Topics: Humans; Rhinoplasty; Nose Deformities, Acquired; Nasal Septum; Cartilage; Nose Diseases
PubMed: 37873992
DOI: No ID Found -
European Annals of Otorhinolaryngology,... Oct 2017The nose is the central organ of the face. It has two essential roles, aesthetic and breathing. It is often seriously damaged in the context of facial burns, causing... (Review)
Review
The nose is the central organ of the face. It has two essential roles, aesthetic and breathing. It is often seriously damaged in the context of facial burns, causing grotesque facial disfigurement. As this disfigurement is visible on frontal and profile views, the patient suffers both socially and psychologically. The nose is a three-dimensional organ. Reconstruction is therefore more difficult and needs to be more precise than in other parts of the face. Maintaining symmetry, contour and function are essential for successful nasal reconstruction. Multiple factors determine the optimal method of reconstruction, including the size of the defect, its depth and its site. Satisfactory social life is recovered only after multiple surgical procedures and long-term rehabilitation and physiotherapy.
Topics: Burns; Burns, Chemical; Facial Injuries; Humans; Nose; Nose Deformities, Acquired; Patient Satisfaction; Plastic Surgery Procedures; Reoperation; Rhinoplasty; Surgical Flaps; Treatment Outcome
PubMed: 28336256
DOI: 10.1016/j.anorl.2017.02.014 -
Ear, Nose, & Throat Journal Mar 2012Outcome measures are a crucial tool in the analysis and comparison of medical interventions. We review the subjective and objective methods of assessing outcomes of... (Review)
Review
Outcome measures are a crucial tool in the analysis and comparison of medical interventions. We review the subjective and objective methods of assessing outcomes of rhinoplasty and septorhinoplasty. Both form and function of the nose are considered.
Topics: Esthetics; Humans; Manometry; Nasal Obstruction; Nasal Septum; Photography; Rhinoplasty; Surveys and Questionnaires; Treatment Outcome
PubMed: 22430341
DOI: 10.1177/014556131209100315