Buccal sulcus versus intranasal approach for postoperative periorbital oedema and ecchymosis in lateral nasal osteotomy

Ghazipour, Ali; Alani, Nadereh; Lahiji, Shervin Ghavami; Dilmaghani, Nader Akbari

doi:10.1016/j.jcms.2014.04.010

Cited by 10 publications

(8 citation statements)

References 15 publications

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“…This is attributed to the preservation of the supra-periosteal vessels and lymphatics, better nasal bone support, and better blood drainage to the mouth rather than nasal mucosa. 28 Additionally, an internal noninterrupted continuous lateral osteotomy can be performed without nasal mucosal incisions, which may scar the internal nasal valve area 29 and reduce nasal air inflow postoperatively. 30 Also, the UBSA gives direct access to the ANS, columella, and caudal septum, which in well-trained hands can be adequate to perform many steps of septorhinoplasty, as it gives direct access to fix the septum to the ANS and to manage the maxillary crest spurs objectively.…”

Section: Discussionmentioning

confidence: 99%

Nasal Tip Depressor Manipulation through Upper Buccal Sulcus Approach in Selected Open Primary Rhinoplasties

Elgazzar

Elshahat

Lashin

2022

Plastic and Reconstructive Surgery - Global Open

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Background: During smiling, the prominent action of nasal tip depressors (NTDs) antagonizes the rhinoplasty nasal tip support maneuvers and favors scarring forces‚ pulling the nasal tip in a less projecting vector. The NTDs' disinsertion is feasible through the open rhinoplasty approach. Yet, the reliability of the open approach to manipulate all NTD attachments is still questionable. The upper buccal sulcus approach (UBSA) is a reliable approach to manipulate variable anatomy of the NTDs. Methods: Thirty-two patients had primary open rhinoplasty between 2016 and 2020. All patients showed hyperactive NTDs during smile preoperatively. Through UBSA, disruption of NTDs was done. Aesthetic outcome was evaluated by comparing the pre/postoperative nasal tip projection (NTP) and nasolabial angle (NLA) in lateral views. Results:The sample included 28 women and four men, and the mean age was 30.7 years. The mean follow-up period was 23.8 months. Preoperatively, 53% (n = 17) of patients showed normal NTP measurements; this percentage increased to 87.5% (n = 28) postoperatively. The mean NLA for the 32 patients was 91.0 degrees pre-operatively‚ which was increased to 102.5 degrees postoperatively. These aesthetic results were maintained throughout the follow-up period‚ with no significant increase in the incidence of complications. Conclusions:The combination of the UBSA with open rhinoplasty resulted in objective visualization and manipulation of the NTDs. This was proven by the maintained NTP and NLA in aesthetic optimum values throughout the follow-up period. We believe that UBSA can be safely combined with open rhinoplasty as a reliable hidden approach to manipulate hyperactive NTD cases.

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Section: Discussionmentioning

confidence: 99%

Nasal Tip Depressor Manipulation through Upper Buccal Sulcus Approach in Selected Open Primary Rhinoplasties

Elgazzar

Elshahat

Lashin

2022

Plastic and Reconstructive Surgery - Global Open

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“…They found buccal sulcus technique to cause meaningful decrease in the incidence of upper and lower eyelid edema and upper eyelid ecchymosis. 6 In this study, for the first time, we compared 2 different instruments for internal lateral osteotomy regarding edema and ecchymosis. Repositioning the nasal dorsum and narrowing the nasal base can be frightening for beginners.…”

Section: Discussionmentioning

confidence: 99%

“…In order to define the degree of postoperative ecchymosis and edema, we used grading method ( Table 1). 6 We evaluated postoperative edema and ecchymosis day 2 for both side of nose using postoperative photographs ( Figure 2). The analysis of postoperative photographs was performed blindly.…”

Section: Methodsmentioning

confidence: 99%

A New Instrument For Rhinoplasty: The Osteotom With Lighting Guide Transilluminating Osteotomy

Ersözlü

2019

Ear Nose Throat J

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Rhinoplasty remains one of the most commonly performed aesthetic surgical procedure that demands a meticulous intraoperative precision as well as maximum precaution and control. Nasal osteotomy is a key component to shape the bony vault in aesthetic rhinoplasty, but it is also the so versatile, dangerous, and difficult to learn. The present study aims to evaluate the usefulness of our locator instrument for beginners which is called transilluminating osteotome. The use of transilluminating osteotome instead of guided lateral nasal osteotome is a reliable instrument since it facilitates the localization of osteotome and osteotomy line beneath the soft tissue with a limited damage to the surrounding soft tissues. Level of Evidence: III

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“…33 A significantly lower incidence of upper and lower eyelid edema and upper eyelid ecchymosis was seen on both the second day and after the seventh day when an enoral buccal sulcus approach was used compared with an intranasal approach in a prospective study. 34 Significantly less swelling and bruising were seen after continuous endonasal lateral osteotomy in the endonasal approach as compared with the external approach. 35 Also, postoperative first-day edema and postoperative seventh-day ecchymosis scores were significantly better in the patients who had been operated through an endonasal approach as opposed to an external approach with the lateral osteotomy in both groups being an external perforating osteotomy.…”

Section: Choice Of the Osteotome And Osteotomy Techniquementioning

confidence: 91%

Reducing Periorbital Edema and Ecchymosis after Rhinoplasty: Literature Review and Personal Approach

Tasman

2018

Facial plast Surg

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Postoperative periorbital edema and ecchymosis are most bothersome to rhinoplasty patients. The degree of swelling and bruising is influenced by several factors, and numerous prophylactic and therapeutic measures have been described in the literature. This article reviews the current literature and concludes with the author's suggestions on how to best minimize postoperative periorbital edema and ecchymosis.

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Buccal sulcus versus intranasal approach for postoperative periorbital oedema and ecchymosis in lateral nasal osteotomy

Cited by 10 publications

References 15 publications

Nasal Tip Depressor Manipulation through Upper Buccal Sulcus Approach in Selected Open Primary Rhinoplasties

Nasal Tip Depressor Manipulation through Upper Buccal Sulcus Approach in Selected Open Primary Rhinoplasties

A New Instrument For Rhinoplasty: The Osteotom With Lighting Guide Transilluminating Osteotomy

Reducing Periorbital Edema and Ecchymosis after Rhinoplasty: Literature Review and Personal Approach

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