Intermediate osteotomies in rhinoplasty: a new perspective

Nunes, Diogo; Tinoco, Catarina; Carmo, Diogo Oliveira; Paço, João

doi:10.1007/s00405-017-4537-4

Cited by 9 publications

(9 citation statements)

References 9 publications

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“…However, because of the complexity of this anatomic structure, it is so difficult to define the key factors, which could lead to the contradictory conclusions. As an important part of nose, the nasal dorsum plays a major role in nasal and facial harmony (Pereira et al, 2017). Analysis of rhinoplasty results has shown that even slight differences in nasal shape can transform the look of an individual’s face (Aston and Guy, 1977), the key point being that one might be able to distinguish the effect of the different factors on nasal dorsum deformity because of its simpler anatomic structure.…”

Section: Introductionmentioning

confidence: 99%

Radiologic Evaluation of the Influence of Cleft Treatment on Nasal Dorsum Growth

Liu

Shi

et al. 2020

The Cleft Palate Craniofacial Journal

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Objective: The study addresses whether the growth of the nasal dorsum is disturbed by cleft treatments, for cleft lip only (CL) and cleft lip with cleft palate (CLP). Design: A total of 576 patients with cleft (278 CL, 298 CLP) and 333 individuals without orofacial clefts were retrospectively enrolled. Cleft lip only group was treated with a modified Millard technique combined with Tajima incision for rhinoplasty at 3 to 6 months. The CLP group underwent the same lip repair technique and then underwent a Sommerlad palatoplasty at 9 to 12 months. Lateral cephalometric radiographs of all individuals were taken to evaluate the nasal length and nasal dorsum height. Dunn test was used to analyze the difference ( P < .001). Results: Compared with control, in CL, nasal bone angle and nasal dorsum angle increase by age similarly (5-18 years, P > .05); the total dorsum is significantly shorter (5-18 years, P < .001), while the upper nasal dorsum length is similar (except in 5-6 years), and the lower nasal dorsum is shorter (5-18 years, P < .001). In CLP, nasal bone angle develops insufficiently as children grow (8-18 years, P < .001); the nasal dorsum angle is notably smaller (5-18 years, P < .001); nasal bone length is not significantly different except 11 to 13 years ( P < .05); nasal dorsal length is similar at skeletal maturity (17-18 years, P > .05), although it is shorter during 8 to 16 years ( P < .05); the upper nasal dorsum is overdeveloped (14-18 years, P < .05), whereas the lower nasal dorsum is underdeveloped (5-18 years, P < .001). Conclusion: Treatments in both CL and CLP could be the important factors in disturbing the growth of cartilaginous portion of the nasal dorsum (including nasal tip) and the nasal dorsum height.

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Section: Introductionmentioning

confidence: 99%

Radiologic Evaluation of the Influence of Cleft Treatment on Nasal Dorsum Growth

Liu

Shi

et al. 2020

The Cleft Palate Craniofacial Journal

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“…In a similar study [4] (Intermediate osteotomies in rhinoplasty: a new perspective), the results were used for calculation of the sample size with a study power of 80% and alpha error of 0.05. The minimum number calculated was 18 (9 patients per group) using Medcalc software.…”

Section: Sample Size Calculationmentioning

confidence: 99%

“…The different types of osteotomies (medial, lateral, intermediate, and transverse) can be performed and combined to avoid airway dysfunction. Recently, intermediate osteotomies have been routinely performed in patients with a change in eyebrow-tip line harmony [4]. Different approaches were described; the most popular are the external percutaneous perforating osteotomy and the internal endonasal continuous osteotomy.…”

Section: Introductionmentioning

confidence: 99%

Comparative study between different types of intermediate osteotomies in twisted nose deformity management: a randomized controlled trial

Sabaa,

Elfouly,

Elemam

2024

Egypt J Otolaryngol

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Background The nasal dorsum plays an important role in defining the facial harmony. Osteotomy techniques in rhinoplasty surgery are challenging, as in many cases they require visionless tissue manipulation to achieve an aesthetic facial symmetry. This research elucidates the aesthetic outcome of the different types of intermediate osteotomies for correction of twisted nose deformity. Patients and methods This study was randomized controlled trial on 20 selected patients, divided randomly into 2 groups: group A included 10 patients who underwent routine vertical intermediate nasal osteotomies, while group B involved 10 patients subjected to transverse intermediate nasal osteotomies. Patients were assessed aesthetically both by the surgeon and a layperson based on pre and postoperative VAS scale and frontal view photography. Results Comparing pre and postoperative VAS showed statistically significant improvement with median score improvement from 8 pre to 1–2 post which is 80% improvement with P value of 0.004 for surgeon and 0.004 for layperson. Comparing the postoperative VAS for both groups showed statistically insignificant difference with P value of 0.106 for surgeon and 0.218 for lay person. Conclusion Twisted nose deformity is one of the challenging cases in rhinoplasty. Both types of intermediate osteotomies have shown significant improvement in postoperative dorsal aesthetic view. There was no statistically significant difference between either group; yet, more improvement was noted in the transverse type.

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“…However, because of the complexity of this anatomic structure, it is so difficult to define the key factors. As an important part of nose, the nasal dorsum plays a major role in nasal and facial harmony 5 .Analysis of rhinoplasty results has shown that even slight differences in nasal shape can transform the look of an individual’s face 6 , the key point being that one might be able to distinguish the effect of different cleft types on nasal dorsum deformity, because of its simpler anatomic structure.…”

Section: Introductionmentioning

confidence: 99%

Radiologic Evaluation of the Influence of Cleft Type on Nasal Dorsum Growth

Liu

Shi

et al. 2019

Preprint

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32 Purpose: The study was designed to evaluate whether intrinsic morphological 33 characteristics of the nasal dorsum are affected by cleft type, specifically cleft lip only 34 (CL) and cleft lip with cleft palate(CL/P).35 Methods: 576 cleft patients (278 CL only, 298 CL/P), and 333 individuals without 36 orofacial clefts were retrospectively enrolled. Lateral cephalometric radiographs of all 37 individuals were taken to evaluate the nasal length and nasal dorsum height. Dunn's 38 test was used to analyze the difference (p < 0.001).39 Results:In CL and control, the angulation of the nasal bone and nasal dorsum increase 40 by age similarly (5y-18y, p>0.05). In CL, the total dorsal length is significantly shorter 41 (5y-18y, p<0.001). Although the upper nasal dorsum is similar (except in 5y-6y), the 42 lower nasal dorsum is shorter (5y-18y, p<0.001). 43In CLP, there is no significant difference in the nasal bone angle compared with 44 controls between 5y-7y. However, it develops insufficiently as children grow (8y-18y, 45 p<0.001). The nasal dorsum angle is notably smaller (5y-18y, p<0.001). Nasal bone 46 length is not significantly different from control at all stages except during ages 11y-47 13y (p<0.05). Total nasal dorsal length is similar to the control at skeletal maturity 48 (17y-18y，p>0.05), although it is shorter during 8y to 16y (p<0.05). The upper nasal 49 dorsum is overdeveloped (14y-18y, p<0.05), whereas the lower nasal dorsum is 50 underdeveloped (5y-18y, p<0.001). 51 Conclusion:CL inhibits the growth of nasal dorsum length, leading to short nose 52 deformity. CL/P patients are prone to saddle-nose deformity because of the diminished 53 nasal height (decreased nasal angle). 54 Keywords: Cleft nose; nasal deformity; cephalometric; cleft lip and palate 55 56 57 Introduction 58 Cleft lip is frequently accompanied by nasal deformities. The congenital anatomic 59 deficiency or aberrancy, potential changes related to growth, the cleft itself, and even 60 scarring from previous procedures are the main factors which lead to a wide variability 61 in secondary cleft nasal deformities and the complexity of surgical techniques over the 62 past few years 1 . Subsequently, secondary surgery for the cleft nasal deformity 63 undeniably presents a formidable challenge to the plastic surgeon, and the results are 64 not as ideal as expected due to lack the comprehensive inward characters that hidden 65 under complex deformed manifestations. 66 Due to its central location, the nose plays a prominent role in facial aesthetics 2 . 67 How does one distinguish the different factors that contribute to the cleft nasal 68 deformity, including cleft type, intrinsic potential changes, or surgical damage? 69 Nowadays, surgeons mainly define the cleft nasal malformation with regard to the alar 70 base, columella, nostril, nasal tip, nasal floor, and nasal septum， attaching more 71 importance to the dysmorphia of the nasal tip 3,4 . However, because of the complexity 72 of this anatomic structure, it is so difficult to define the k...

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Intermediate osteotomies in rhinoplasty: a new perspective

Cited by 9 publications

References 9 publications

Radiologic Evaluation of the Influence of Cleft Treatment on Nasal Dorsum Growth

Radiologic Evaluation of the Influence of Cleft Treatment on Nasal Dorsum Growth

Comparative study between different types of intermediate osteotomies in twisted nose deformity management: a randomized controlled trial

Radiologic Evaluation of the Influence of Cleft Type on Nasal Dorsum Growth

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