The keystone area of nose is a clinically important structure for maintaining the stability of dorsum of nose. However, anthropometric data for individual structure constituting the keystone area were less studied. Dissections of external nose were performed in 12 cadavers for measuring the length and width of structural components of keystone area. Shape of nasal bones and the overlap area between upper lateral cartilage and nasal bonewere classified. Measurements of the keystone area were also performed in 380 MRI and PACS images. Types of the caudal margin of nasal bone were classified as follows; type A: flat margin, type B: M shape, type C: extended midline, type D: retracted midline. Types of overlapped portion between upper lateral cartilage and nasal bone were categorized as follows; type Ao: flat midline, type Bo: short elongated midline, type Co: long elongated midline. Overlap length of upper lateral cartilage with nasal bone was 4~9 mm (mean 6.5 mm)in the midline, 0~4.5 mm (mean 2.7 mm)in the paramedian area of nasal bone. Overlapped width of upper lateral cartilage with nasal bone was 8~14 mm(mean 9.7 mm). Individual component of the keystone area has various shape and overlapped length. Therefore, cautious preoperative and intraoperative evaluation of each component is necessary for a safe nasal surgery.
Cadaver ; Cartilage ; Nasal Bone ; Nasal Septum ; Nasal Surgical Procedures ; Nose ; Rhinoplasty

Endoscopes ; Humans ; Nasal Cavity ; surgery ; Nasal Septum ; surgery ; Reconstructive Surgical Procedures ; Rhinoplasty ; Surgical Flaps

BACKGROUND AND OBJECTIVES: Various techniques have been reported for the correction of deviated nasal septum, most of them for caudal septal cartilage. For deviated posterior septal cartilage, the typical method of the day is the resection of deviated portion. However, we developed a bone anchoring technique that conservatively corrects deviated posterior septal cartilage. The aim of the current study is to determine the efficacy of this bone anchoring technique. SUBJECTS AND METHOD: The patients who had undergone septoplasty using bone anchoring technique by a single surgeon (J.S.K) between October 2015 and June 2016 were enrolled in this study. The result of the surgery was evaluated using a visual analogue scale (VAS, ranged 0– 10) for nasal obstruction, acoustic rhinometry, and assessment of surgeon. RESULTS: A total of 44 patients were included in this study. The VAS of nasal obstruction was significantly decreased after surgery from 7.5±1.7 to 2.4±1.4. In acoustic rhinometry, minimal cross-sectional area and volume were increased after surgery from 0.35±0.18 to 0.52±1.40 cm2 and from 3.6±1.1 to 5.8±1.5 cm3, respectively. Most of the deviated septum was well corrected, and complication or recurrence did not developed. CONCLUSION: Bone anchoring technique is easy to perform. It enables the preservation of septal cartilage, which is useful in revision septoplasty or rhinoplasty. We conclude that this technique is a good method for the correction of deviated posterior septal cartilage.
Cartilage ; Humans ; Methods ; Nasal Obstruction ; Nasal Septum* ; Reconstructive Surgical Procedures ; Recurrence ; Rhinometry, Acoustic ; Rhinoplasty ; Suture Anchors*

No abstract available.
Nasal Surgical Procedures*

A short nose is one that extends less than one third of the vertical height of the face or whose distance from nasion to tip-defining point is short. Lengthening short noses has been regarded as one of the most challenging and at times vexing tasks in secondary nasal surgery. For correction of short nose, nasal tip supporting tissues from alar cartilages are released and nasal tip is positioned and fixed again. There are five important nasal tip supporting tissues, fibrous connection between upper lateral cartilage and lower lateral cartilage, hinge region(fibrous connection between lateral border of lateral crus and pyriform aperture), interdormal attachment to anterior septal angle (fibrous tissue between anterior septal angle and middle crus), fibrous connection between septum and foot plate of medial crus and dermocartilaginous ligament. This study is to find out which one of the five nasal tip supporting tissues is the most important in short nose correction except dermocartilaginous ligament which has to be released during rhinoplasty. We dissected ten noses from ten fresh cadavers. Five were male and five were female with an average age of sixty three for all ten. We measured the distance between anterior septal angle and tip-defining point in every step of soft tissue dissection releasing the alar cartilage and mucosa, that are often released in short nose corrections and caudally pulling them to the direction of tip-defining point. First, distances were measured in resting and in pulling of alar cartilage. Further, changed distance were measured after releasing nasal tip supporting tissues beginning from the dissection of soft tissues between lateral crus and upper lateral cartilage to that of mucoperichondrium underneath upper lateral cartilage and septal mucoperichondrium. In each process, we found the average and standard variation, confirmed effects of those values to the lengthening of short noses. Dissecting upper lateral cartilage and lateral crus of alar cartilage was most effective in short nose correction. We also found it effective to release the hinge area and dissect the mucoperichondrium under upper lateral cartilage in lengthening the short noses.
Cadaver ; Cartilage ; Female ; Foot ; Humans ; Ligaments ; Male ; Mucous Membrane ; Nasal Surgical Procedures ; Nose* ; Rhinoplasty

BACKGROUND AND OBJECTIVES: To report the preliminary results of the footplate suture technique for narrowing the columellar base to improve nasal respiration and the cosmetic features of the nasal sill. MATERIALS AND METHODS: Patients with nasal obstruction who presented with external nasal valve obstruction were treated with the footplate suture technique. Data on the patient characteristics, operative procedures, and outcomes were gathered from medical records. RESULTS: Five patients were included in this study. The footplate suture technique was used in all patients, together with septoplasty, batten graft and inferior turbinoplasty to improve the nasal valve obstruction as needed. In each case, divergent footplate segments of the medial nasal alar crura were identified and tied to medialize and narrow the columellar base. All patients had satisfactory subjective nasal breathing and cosmetic results. CONCLUSIONS: The footplate suture technique is an adjunctive procedure that improves the nasal obstruction and nasal sill disfiguration caused by external nasal valve obstruction, especially due to the divergent footplate segments of the medial alar crura.
Cartilage ; Humans ; Medical Records ; Nasal Obstruction ; Respiration ; Rhinoplasty ; Surgical Procedures, Operative ; Suture Techniques* ; Sutures ; Transplants

BACKGROUND AND OBJECTIVES: Caudal and/or dorsal septal deformities cause blockage of nasal passages and result in the external deformities of the nose. As these septal deformities can not be corrected by submucosal resection or septoplasty, the surgical correction of these nasal deformities is a difficult challenge. Functional and aesthetic results of total septal reconstruction provide the validity of total septal reconstruction. Material and Methods : This retrospective study reviewed the patients' records in case of "total septal cartilage reconstruction" for severely twisted scoliotic nose. Fifteen cases were detected as "total septal reconstruction" between January, 1998 and December, 1999. All cases were approached externally, and we followed up the patients from three months to one year by analyses with photography, rhinologic examination, and patients' survey. RESULTS: All patients noted marked improvement of nasal obstruction. Aesthetic improvement of the nose was mostly obtained in fourteen cases. No infection, hematoma, graft extrusion, saddle nose deformity, or distortion occurred in this series. CONCLUSION: Total septal reconstruction through external rhinoplasty approach is a suitable technique to obtain satisfactory aesthetic and functional results in severely deformed noses with caudal and/or dorsal septal deformities
Cartilage ; Congenital Abnormalities* ; Hematoma ; Humans ; Nasal Obstruction ; Nose ; Photography ; Reconstructive Surgical Procedures ; Retrospective Studies ; Rhinoplasty* ; Transplants

OBJECTIVES: To explore the micro-plastic operative treatment of deviated nose combined with nasal septum deviation. METHODS: We designed the incision at the caudal side of the nasal septum. The three-line reduction method for correcting nasal septum deviation was performed. The connection of the caudal nasal septum and the anterior nasal spine was reposited. The micro-plastic surgery with fixed suture was used to correct the deviated nose. RESULTS: After the surgery, the nasal septum deviation was corrected, whose nasal function and symptoms improved without nasal adhesion, nasal septum perforation or other complications. Meanwhile, the nasal tips were in the middle place and nasal dorsums were straight. The aesthetic outcome was satisfactory. CONCLUSIONS Compared to the traditional orthopedic technique, the micro-shaping technique can be used for the homochromous operation of crooked nose combined with nasal septum deviation with less injury and lower risk. We suggest this micro-shaping technique be used in a rational way.
Humans ; Nasal Septum ; surgery ; Nose ; surgery ; Nose Deformities, Acquired ; surgery ; Reconstructive Surgical Procedures ; Rhinoplasty ; methods ; Sutures

BACKGROUND AND OBJECTIVES: Although there are many different reasons for rhinoplasty, there has not been any been systematic research conducted about different motivations patients have. The motivation for the surgery, the preferred shape of nose, the concerns about surgery, the terms needed to make the decision were different and greatly depended on the circumstances. MATERIALS AND METHODS: Two hundred and seventeen persons who have been operated in the Inha Hospital from 1996 to 2000 have been consulted. The survey paper is constituted by fifty-one multiple-choice questions. RESULTS: For the question asking the main reason for wanting rhinoplasty, the majority answered it was to restore their injured nose. The next popular answer was the desire to have a better-shaped nose. For male patients, their deviated nose was caused by injury or accident, and thus desired to have the normal or the original shape of nose by operation. The survey revealed a different result for the opposite sex. The main reason for female patients' wanting rhinoplasty was to have a good-looking nose, and for that purpose they expressed their desire to heighten their nose. Interestingly, the concern about the side effects after the surgery was the greatest reason for avoiding rhinoplasty. CONCLUSION: Every surgery should be well-prepared with the exact analysis of the patient's nasal history and his special request.
Esthetics ; Female ; Humans ; Male ; Motivation ; Nasal Surgical Procedures* ; Nose ; Psychoanalysis* ; Rhinoplasty

Alar rim deformity is one of the most challenging problems to correct in nasal surgery. It is difficult to correct, recurs easily, and needs delicate handling. The technique to correct a hanging alar includes excision a vestibular skin, direct skin excision, and/or excision of the lateral crus. The technique to correct the minimal-to-mild alar retraction includes scar contracture release, alar rim grafts, V-Y advancement flap and composite grafts. In case of severely retracted alar, several techniques such as lateral crural strut graft, alar spreader graft, inter-cartilaginous graft, and island pedicled advancement flap of the nasal dorsum can help to correct the deformities. Alar rotation flap, septal extension graft, alar base surgery, and derotation graft also have some benefit.
Cicatrix ; Congenital Abnormalities* ; Contracture ; Diagnosis* ; Nasal Surgical Procedures ; Rhinoplasty ; Skin ; Transplants