Techniques différentes de la rhinoplastie de la pointe nasale Introduction: La rhinoplastie est considérée comme l'un des objectifs les plus provocateurs dans la chirurgie plastique et la rhinoplastie de la pointe nasale le plus controversé défi face au chirurgien qui la pratique. Il n'y a aucun procédé de routine utilisé et il existe beaucoup de méthodes de reconstruction qui rendent la pointe nasale plus attrayante. But: Le but de cette étude est l'évaluation des différentes techniques de correction afin d'améliorer les résultats dans la rhinoplastie de la pointe nasale. Méthodes: On a réalisé une étude prospective sur tous les patients avec des anomalies de la pointe nasale, soumis à une rhinoplastie fermée ou ouverte entre décembre 2015-aout 2016, à l'Hôpital de Bombay, de l'Inde. Les patients ont été divisés en deux groupes : le groupe A-ou les patients ont été traités par de divers types de sutures (12 cas) et le groupe B dont les patients ont été traités par des sutures et des greffes de la pointe nasale (18 cas). Résultats: L'étude a compris 30 patients, 24 (80%) femelles et 6 (20%) mâles. Douze patients (40%) aux pointes nasales bulbeuses, 7(23%) patients aux pointes ABSTRACT Background. Rhinoplasty is considered as one of the most challenging objectives in plastic surgery and tip rhinoplasty is arguably the greatest challenge for the surgeon performing rhinoplasty. No routine tip procedure is ever used and there are many ways to reconstruct and make nasal tips more attractive. Objective. The aim of this study was to evaluate the different correction techniques, in order to improve the outcomes in tip rhinoplasty. Methods. A prospective study was performed, including all patients with nasal tip deformities who underwent closed or open rhinoplasty between December 2015-August 2016 in Bombay Hospital, India. The patients were divided into two groups: group A-treated with various types of tip sutures (12 cases), and group B-treated with combined tip sutures and grafts (18 cases). Results. The study included 30 patients, 24 (80%) females and 6 (20%) males. 12 (40%) were patients with bulbous tips, 7 (23%) were patients with droopy tips, 5 (17%) were patients with boxy (broad) tips, 3 (10%) were patients with wide tips, and 3 (10%) were patients with bifid tips. A total of 27 (90%) cases involved primary rhinoplasties, and 3 (10%) cases involved revision. Patient's and doctor's satisfactions were recorded

Facial nerve paralysis is a debilitating condition with multiple etiologies, with aesthetic, functional, psychological and social impact. Given the complex multitude of causes that may generate such condition, a therapeutic algorithm is mandatory when attempting reconstruction. Severity, timing, patient adherence to a rehabilitation program, status of ipsilateral and contralateral facial nerves and particularities of each patient are all criteria which should be accounted when choosing a treatment option. After initial assessment, a variable treatment panel is available based on condition type include medicamentous therapy, rehabilitation program, dynamic and static procedures surgical procedures, having as primary aim functional restoration achieving aesthetic balanced facial features. This paper summarizes current knowledge in facial paralysis reconstruction and presents an algorithmic approach that eases decision making and therapeutic strategy.

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