No abstract

Orbital emphysema following rhinoplasty is an extremely rare complication. Only one case of sub-dermal emphysema was reported in the English literature following rhinoplasty directly in post-operative period and one reported case of sudden orbital emphysema during septorhinoplasty operation. A 29 year old male underwent open septorhinoplasty. Surgery was un eventful and no nasal packs were placed after surgery. Hours after surgery he developed right orbital swelling following forceful nose blowing and sneezing. CT scan showed extensive right orbital and peri-orbital emphysema extending to the right infra-temporal fossa. Emphysema was gradually resolving without any complications and disappeared completely on the 10th day post-operatively.

Alar base resection is an essential part of rhinoplasty which is frequently utilized to narrow a wide nasal base or to correct excessive flaring of the lateral ala extending beyond the alar-facial groove. Multiple surgical techniques have been described in the literature including alar wedge excision, sill reduction, a combination of wedge and sill reduction, repositioning the alar insertion with a V-Y advancement flap, alar flap advancement, and multiple suturing techniques. The authors of this article propose a technique that can be used to correct excessive alar or sill reduction if encountered intraoperatively.