OBJECTIVETo observe and analyse the dissection of the tunnels in traditional blind operation of augmentation rhinoplasty.

METHODS11 Cases of augmentation rhinoplasty were collected and be observed by an endoscope as soon as the tunnels were formed during the operations.

RESULTS(1) Some of the tunnels did not go through one layer. (2) The bilateral cartilage separated in the mid-line. (3) There were two blood vessels in the surface of alar cartilage. There were perforating blood vessels in the edge of pyriform aperture. (4) In some cases whose incision were in unilateral alar margin, the tunnel were asymmetric.

CONCLUSIONIn some cases of traditional blind operation of augmentation rhinoplasty, tunnels were not suitable, they were asymmetric; and there were desmo and septa in the tunnels. Those might be the causes of complications post-op of augmentation rhinoplasty.

Humans ; Nasal Septum ; surgery ; Rhinoplasty ; methods ; Sutures

BACKGROUND: Rehabilitation of normal function and form is essential in cleft lip repair. In 2005, Dr. David M. Fisher introduced an innovative method, named “an anatomical subunit approximation technique” in unilateral cleft lip repair. According to this method, circumferential incision along the columella on cleft side of the medial flap is continued to the planned top of the Cupid's bow in straight manner, which runs parallel to the unaffected philtral ridge. Usually, small inlet incision is needed to lengthen the medial flap. On lateral flap, small triangle just above the cutaneous roll is used to prevent unesthetic shortening of upper lip. This allows better continuity of the Cupid’s bow and ideal distribution of tension. CASE PRESENTATION: As a modification to original method, orbicularis oris muscle overlapping suture is applied to make the elevated philtral ridge. Concomitant primary rhinoplasty also results in good esthetic outcome with symmetric nostrils and correction of alar web. As satisfactory results were obtained in three incomplete and one complete unilateral cleft lip patients, indicating Fisher’s method can be useful in cleft lip surgery with functional and esthetic outcome. CONCLUSIONS: Clinically applied Fisher's method in unilateral cleft lip patients proved the effectiveness in improving the esthetic results with good symmetry. This method also applied with primary rhinoplasty.
Bays ; Cleft Lip ; Humans ; Lip ; Methods* ; Rehabilitation ; Rhinoplasty ; Sutures

Deviated nose deformities have always been a surgical challenge, and it is essential to achieve both functional and esthetic improvements. Various techniques have evolved over time to correct deviated noses but no one method applies in all cases. Successful correction requires a complete understanding of the various surgical techniques and concepts, including the three-dimensional nasal structure and the time-related changes to surgically-treated noses.
Congenital Abnormalities ; Methods ; Nasal Septum ; Nose Deformities, Acquired ; Nose* ; Rhinoplasty

BACKGROUND AND OBJECTIVES: The surgical techniques based on the classification system based on Western individuals for the correction of deviated nose should be modified because of the differences in the anatomy of the nose for Korean individuals. To evaluate the usefulness of a classification system that has been designed for the esthetics and deviated nose of Korean individuals, we used that to analyze the surgical outcomes of rhinoplasty for deviated nose for 76 Korean patients. SUBJECTS AND METHOD: Seventy six patients who underwent rhinoplasty for deviated nose between January 2010 and June 2016 were reviewed retrospectively. All patients were classified with Jang's classification system and surgical techniques were analyzed according to the classification. Surgical outcomes were evaluated based on the preoperative and postoperative photo taken of the patient's nose. The degree of nasal deviation, tip projection index, nasofrontal angle and columellar-labial angle were measured. RESULTS: Deviated nose was classified into type I (34%), type II (26%), type III (13%), type IV (9%), and type V (17%). Preoperative and postoperative anthropometric measurements revealed that the mean degree of deviation changed from 8.84° to 3.01° (p < 0.01); the tip projection index changed from 0.54 to 0.58 (p < 0.01), and the degree of nasofrontal angle changed from 131.55° to 133.14° (p < 0.01). Aside from the residual deviations, complications included a shifting of the dorsal graft, an inverted V-deformity from the depression of the middorsum after the spreader graft and incomplete hump removal. CONCLUSION: Analysis based on the said classification system and personal esthetics showed good surgical outcomes for rhinoplasty to correct deviated nose. Therefore, it would be helpful to treat Korean patients for the correction of deviated nose by using both classification system and personal esthetics that are based on Korean individuals.
Classification ; Depression ; Esthetics ; Humans ; Methods ; Nose* ; Retrospective Studies ; Rhinoplasty* ; Transplants

Feasibility Studies ; Humans ; Nose ; Rhinoplasty ; methods ; Tampons, Surgical

BACKGROUND AND OBJECTIVES: Osteotomy, usually carried out bilaterally, is a commonly performed procedure to correct the bony dorsum of deviated nose. However, it is an invasive maneuvers which can affect the stability of nasal bone and develop complications, such as, edema and ecchymosis. This study aims to evaluate the usefulness of unilateral osteotomy in correcting a deviated nose with various scoliosis. SUBJECTS AND METHOD: We studied 9 of the 69 patients who underwent corrective rhinoplasty with unilateral osteotomy to correct the bony nasal dorsum between 2010 and 2014. For patients whose bony nasal dorsum was corrected well after performing osteotomy on the convex side of the bony dorsum, the opposite side was not operated on; however, if correction was incomplete, osteotomy was additionally performed on the opposite side. For this study, patients who underwent bilateral osteotomy were excluded from the study. The improvement of correction was assessed by comparing the preoperative and postoperative photos. RESULTS: Of the nine patients treated with unilateral osteotomy, 5 cases were C or reverse C type deviations, 1 case was S type deviation and 3 were straight deviations. Five of the nine patients improved greatly and the rest improved significantly. None of the patients experienced worsening change postoperatively. CONCLUSION: Osteotomy is essential but invasive maneuver, so it is desirable to reduce the number of times to execute. By performing osteotomy on the convex side of the nose first, we can correct the deviated nose effectively while reducing the number of implementation.
Ecchymosis ; Edema ; Humans ; Methods ; Nasal Bone ; Nose* ; Osteotomy* ; Rhinoplasty ; Scoliosis

OBJECTIVES: The long-term effect of muscular force balance reconstruction technique combined with intranasal fixation for correcting secondary nasolabial deformity after unilateral cleft lip was evaluated. The aim was to provide a basis for further improving the surgical treatment effect of secondary nasolabial deformity of acleft lip. METHODS: A total of 40 patients aged 4-28 years with secondary nasal deformity and unilateral cleft lip were selected as research subjects. The two-dimensional photo measurement analysis method was used in comparing the surgical results before and immediately after the operation (7 d) and 1 year after the operation. RESULTS: Columellar angle, nostril height ratio (NHR), alar rim angle, alar rim angle ratio, and nostril shape (NS) increased dimmediately after the operation, whereas alar base width ratio (ABWR) and nostril width ratio decreased (NHR) immediately after the operation (P<0.01). The ABWR, NHR, and NS immediately after the operation were not significantly different from those 1 year after the operation (P>0.05). CONCLUSIONS Muscular force balance reconstruction technique combined with intranasal fixation is effective in the repair of unilateral secondary nasolabial deformity, and stable results can be obtained 1 year after surgery.
Humans ; Cleft Lip/surgery* ; Nose/abnormalities* ; Rhinoplasty/methods* ; Treatment Outcome

Adult ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; abnormalities ; surgery ; Rhinoplasty ; methods ; Young Adult

BACKGROUND: The nasal septal cartilage is often used as a donor graft in rhinoplasty operations but can vary widely in size across the patient population. As such, preoperative estimation of the cartilaginous area is important for patient counseling as well as operating planning. We aim to estimate septal cartilage area by using facial computed tomography (CT) studies. METHODS: The study was performed using facial CT images taken from 200 patients between January 2012 to July 2015. Using the mid-sagittal image, the boundary of cartilaginous septum was delineated from soft tissue using the mean difference in signal intensity (or brightness). The area within this boundary was calculated. The calculated area for septal cartilage was then compared across age groups and sexes. RESULTS: Overall, the mean area of nasal septal cartilage was 8.18 cm² with the maximum of 12.42 cm² and the minimum of 4.89 cm². The cartilage areas were measured to be larger in men than in women (p<0.05). The area decreased with advancing age (p<0.05). CONCLUSION: Measuring the size of septal cartilage using brightness difference is more precise and reliable than previously reported methods. This method can be utilized as the standard for prevention of postoperative complication.
Cartilage* ; Counseling ; Female ; Humans ; Male ; Methods ; Nasal Cartilages ; Postoperative Complications ; Rhinoplasty ; Tissue Donors ; Transplants