Lateral Crural Repositioning for Treatment of Cephalic Malposition

Toriumi, Dean M.; Asher, Scott A.

doi:10.1016/j.fsc.2014.09.004

Cited by 82 publications

(106 citation statements)

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“…9). 13 In these patients, there are several options for management that fall into two categories: flatten the lateral crura to camouflage versus flatten and reposition (transpose) caudally. From a functional standpoint, lateral wall support of some kind must be added closer to the alar margin to support the lateral compartment and prevent lateral wall weakness or external valve collapse.…”

Section: Cephalically Positioned Lateral Cruramentioning

confidence: 99%

“…An alar rim graft can be added to provide the caudal support needed to stabilize the lateral compartment. 1,9,13 The problem with leaving the cephalically positioned lateral crura in their native position is despite camouflaging (flattening with a lateral crural strut graft [LCSG], tensioning or a turn-in flap), the malpositioned lateral crura can show up over time. This may occur if the flattening fails due to loosening of the tension or failure of the lateral crural strut graft.…”

Section: Toriumimentioning

confidence: 99%

“…Placing a lateral crural strut graft under a bulbous lateral crus flattens the cartilage and increases the lateral wall support. 1,9,13 If the lateral crura are cephalically positioned (angle off of midline <30°), my preference is to release the lateral crura from the vestibular skin and reposition into a more caudal orientation 1,9,13 (Fig. 11 and Supplementary Video S4).…”

Section: Toriumimentioning

confidence: 99%

“…If necessary, two pieces of cartilage can be sutured together to provide the length needed for the lateral crural strut grafts. The pockets for the reoriented lateral crura should start at the lateral aspect of the marginal incision and proceed down the supra-alar groove 1,9,13 (Fig. 12 and Supplementary Video S4).…”

Section: Toriumimentioning

confidence: 99%

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Nasal Tip Contouring: Anatomic Basis for Management

Toriumi

2020

Facial Plastic Surgery & Aesthetic Medicine

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Section: Cephalically Positioned Lateral Cruramentioning

confidence: 99%

Section: Toriumimentioning

confidence: 99%

Section: Toriumimentioning

confidence: 99%

Section: Toriumimentioning

confidence: 99%

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Nasal Tip Contouring: Anatomic Basis for Management

Toriumi

2020

Facial Plastic Surgery & Aesthetic Medicine

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“…The needle was chosen because it is used in rhinoplasty and otoplasty procedures [30][31][32][33]. The diameter was measured as 430 μm.…”

Section: Needle Penetration Testingmentioning

confidence: 99%

Characterisation of the surface structure of 3D printed scaffolds for cell infiltration and surgical suturing

et al. 2016

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A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription.For more information, please contact eprints@nottingham.ac.uk Abstract3D printing is of great interest for tissue engineering scaffolds due to the ability to form complex geometries and control internal structures, including porosity and pore size. The porous structure of scaffolds plays an important role in cell ingrowth and nutrition infusion. Although the internal porosity and pore size of 3D printed scaffolds have been frequently studied, the surface porosity and pore size, which are critical for cell infiltration and mass transport, have not been investigated. The surface geometry can differ considerably from the internal scaffold structure depending on the 3D printing process. It is vital to be able to control the surface geometry of scaffolds as well as the internal structure to fabricate optimal architectures. This work presents a method to control the surface porosity and pore size of 3D printed scaffolds. Six scaffold designs have been printed with surface porosities ranging from 3% -21%. We have characterised the overall scaffold porosity and surface porosity using optical microscopy and microCT. It has been found that surface porosity has a significant impact on cell infiltration and proliferation. In addition, the porosity of the surface has been found to have an effect on mechanical properties and on the forces required to penetrate the scaffold with a surgical suturing needle. To the authors' knowledge, this study is the first to investigate the surface geometry of extrusion-based 3D printed scaffolds and demonstrates the importance of surface geometry in cell infiltration and clinical manipulation.

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Aesthetic and Functional Results of Lateral Crural Repositioning

İlhan¹,

Saribas²,

Caypinar³

2015

JAMA Facial Plast Surg

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IMPORTANCE Thin or cephalically malpositioned lateral crura cause nasal obstruction by depressing nasal valves and decrease patient satisfaction with rhinoplasty as a result of nostril asymmetry and alar collapse.OBJECTIVE To demonstrate the aesthetic and functional efficacy of lateral crural repositioning with lateral strut grafting in patients with cephalic malposition of the lateral crura undergoing primary septorhinoplasty. DESIGN, SETTING, AND PARTICIPANTSWe prospectively selected 80 patients with lateral crural malposition who underwent primary septorhinoplasty performed by the same surgeon from December 1, 2013, through May 30, 2014. The surgeon measured the angle between the lateral crura and midline intraoperatively with a goniometer to confirm malposition (angle, Յ30°). Data analysis was performed from March 13 to 23, 2015. INTERVENTION All the patients underwent primary rhinoplasty with the open approach. Lateral crural repositioning with lateral crural strut graft was used in all selected patients. MAIN OUTCOME AND MEASURES Preoperative and 6-and approximately 12-month postoperative scores on the Nasal Obstruction Symptom Evaluation (NOSE) scale (range, 0-20; decreased scores indicate improved functional results) and the Rhinoplasty Outcomes Evaluation (ROE) questionnaire (range, 0-24; increased scores indicate improved aesthetic results).RESULTS Seventy-five of 80 patients were confirmed to have cephalic malposition intraoperatively. Four patients were excluded owing to selection of different surgical techniques, leaving 71 patients for analysis. The mean (SD) and median postoperative NOSE scores at 6 months (3.18 [3.12] and 2.0) and 12 months (0.39 [1.07] and 0) showed significant improvement compared with the preoperative scores (6.96 [5.10] and 7.0) (P < .01 for each comparison). The mean (SD) and median postoperative ROE scores also showed significant improvement at 6 months (21.06 [3.82] and 23.0) and 12 months (23.12 [2.09] and 24.0) compared with preoperative scores (7.03 [3.70] and 6.0) (P = .001). However, the changes from preoperative to 12-month postoperative scores (mean [SD] and median) were not significantly different between patients with normal (NOSE scores, 8.41 [4.59] and 90 to 0.28 [0.79] and 0, respectively; ROE scores, 6.97 [3.24] and 6.0 to 23.31 [1.91] and 24.0, respectively) and thin (NOSE score, 6.59 [5.09] and 8.0 to 0.11 [0.33] and 0, respectively; ROE scores, 7.76 [3.82] and 7.0 to 23.29 [1.72] and 24.0, respectively) skin types and those with thick skin types (NOSE scores, 5.52 [5.42] and 4.0 to 0.72 [1.54] and 0, respectively; ROE scores, 6.60 [4.16] and 6.0 to 22.80 [2.53] and 24.0, respectively) (P > .05).CONCLUSIONS AND RELEVANCE Lateral crural repositioning is a useful and versatile technique to achieve successful functional and aesthetic results in a 1-year follow-up. We detected no significant difference by skin type in improvement of nasal function and aesthetic satisfaction.LEVEL OF EVIDENCE 3.

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Lateral Crural Repositioning for Treatment of Cephalic Malposition

Cited by 82 publications

References 18 publications

Nasal Tip Contouring: Anatomic Basis for Management

Nasal Tip Contouring: Anatomic Basis for Management

Characterisation of the surface structure of 3D printed scaffolds for cell infiltration and surgical suturing

Aesthetic and Functional Results of Lateral Crural Repositioning

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