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The goal of the nasal tip plastic surgery is to reduce or increase, change the shape or/and projection, rotation and contour the tip. This report presents our technique for the reduction and lifting of the nasal tip with a proportional reduction (trim) of the alar cartilage and suture technique--cranio-caudal transdomal sutures. The aim of this study is to analyze and compare the effectiveness of three tipplasty suture techniques to modify nasal tip projection and rotation. Our research is based on 297 operated patients, 165 of them were women (55, 5%) and 132 were men (44, 5%). Rhinoseptoplasty with open approach was applied to 144 of them (48, 4%) and to 153 (51, 6%) of the patients was applied endonasal (delivery) approach. In this paper we compare the postoperative results of three suture methods. We discuss advantages and shortcomings of our technique, compared with the other surgical procedures. There is no one "right" way to nasal tip surgery, only optimal methods for individual cases.

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Introduction: Choanal atresia is a rare disorder presenting with complete separation between the nasal cavity and the nasopharynx. There are two types of this abnormal blockage of the nasal airway -congenital and acquired. Material and Methods: This paper presents the case of a 54-years-old woman administered to the clinics for septoplasty. During the preoperative diagnostic process via CT scan and endoscope examination a coincidental finding was diagnosed -unilateral congenital choanal atresia. The medical history of the patient revealed difficult nasal breathing which is absent in the right nasal airway, also frequent rhinosinusitis, moreover orthodontic problems with her dentition and malocclusion; regarding her post-birth period she was on feeding tube and with oxygen mask in a neonatal clinic for several months; no facial traumas reported during the rest of her life.Results: Septoplasty was managed and endoscopic assisted fenestration in the choanal regional was performed viatransseptal access. Seven days postoperatively before the removal of the septal splintsa CT scan was performed for evaluation of the surgical treatment and three months later -endoscopy which displayed well-formed without postoperative stenosis neochoana. Conclusion:The congenital choanal atresia is a rare abnormality which determines the insufficient clinical experience with this disorder. It is possible that many cases could have been missed or misdiagnosed because of the low incidence of the condition. The conducted literature review reveals that the case report we are presenting is one of the oldest patients diagnosed with unilateral, congenital, bony choanal atresia.