Management of the unilateral cleft lip nasal deformity is complex because of the underlying significant asymmetry of the lower lateral cartilages and soft tissues of the nasal base. Suturing and ...grafting techniques may leave the patient with residual asymmetries of the nasal tip and nostrils. Some of this residual asymmetry may be attributable in part to the anchoring effect of the vestibular skin attachments to the lower lateral cartilages. This article discusses the use of lateral crural release, repositioning, and support with lateral crural strut grafts to manage the nasal tip. The technique involves freeing the vestibular skin from the undersurface of the lateral crura and domes and placement of lateral crural strut grafts with or without amputation of the ipsilateral dome and lateral crura to allow precise resuturing to the caudal septal extension graft. This technique is coupled with the use of a caudal septal extension graft to stabilize the nasal base and provide a strong foundation for the repair. Treatment of the nasal base may require skeletal augmentation to aid in creating symmetry of the alar insertions. Costal cartilage is needed in most cases to provide adequate structural support. Nuances in technique are discussed to help maximize outcomes.
Auricular Composite Graft Survival in Rhinoplasty Toriumi, Dean M; Kao, Richard; Vandenberg, Taylor ...
Facial plastic surgery & aesthetic medicine,
2023 Jan-Feb, Letnik:
25, Številka:
1
Journal Article
Recenzirano
Auricular composite grafts can be used in rhinoplasty to correct defects of the internal nasal valve, ala, vestibule, sill, and external nose. The objective of this study was to measure the auricular ...composite graft (ACG) survival rate and patient-reported outcome with Nasal Obstruction Symptom Evaluation (NOSE) score among patients undergoing rhinoplasty. A retrospective chart review was performed of all patients who underwent rhinoplasty with ACGs from 2002 to 2019 by the senior author. Median patient age was 42 years (range 14-79) with 80.3% being female. In total, 234 rhinoplasty procedures were performed utilizing 367 auricular composite grafts. Secondary rhinoplasty (
= 160, 68.4%) was the most common. And 93.7% of ACGs had full take. There were 23 partial or total graft failures, producing graft failure rate of 6.3%. Mean preoperative NOSE score was 24.08, and mean postoperative NOSE score was 21.84, with a
-value of 0.63. Auricular composite grafts can be used to repair a wide range of defects of the internal nasal valve, nasal sill-ala junction, nasal vestibule, and external nose.
Preservation Rhinoplasty, Third Edition Toriumi, Dean M
Plastic and reconstructive surgery (1963),
2021-May-01, 2021-05-00, 20210501, Letnik:
147, Številka:
5
Journal Article
After completion of this article, the reader should be able to describe the indications for lateral crural repositioning, understand the key steps to performing the procedure, and be able to manage ...the complications associated with this treatment strategy.
