Management of the Nasal Dorsum in Rhinoplasty

Lee, Michael R. F.; Unger, Jacob G.; Rohrich, Rod J.

doi:10.1097/prs.0b013e31822b6a82

Cited by 84 publications

(31 citation statements)

References 85 publications

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“…Then as now, no comparative studies were identified that compare, for example, a sequential reduction with an en-bloc-reduction of the nasal dorsum [75]. While different retrospective case series describe the applied technique and the outcome, comparisons of different techniques are not possible.…”

Section: Types and Therapies Of Nasal Obstructionmentioning

confidence: 99%

“…While different retrospective case series describe the applied technique and the outcome, comparisons of different techniques are not possible. Although there is almost a consensus regarding augmentation of the nasal dorsum that autologous cartilage is the gold standard, there remains a considerable difference of opinion regarding the donor site and further treatment of the inserted cartilage [75]. Additionally, irradiated costal cartilage and bone transplants appear to be acceptable materials for augmentation of the nasal dorsum.…”

Section: Types and Therapies Of Nasal Obstructionmentioning

confidence: 99%

“…Additionally, irradiated costal cartilage and bone transplants appear to be acceptable materials for augmentation of the nasal dorsum. The use of synthetic implants is controversial; in particular, the application of silicone is considered very critically [75] or fully objected [76] because of potential risks, including extrusion and skin necrosis. Even when the use of Gore-Tex appears to be less risky, the indication should be made very carefully because, there is also a risk of extrusion [75].…”

Section: Types and Therapies Of Nasal Obstructionmentioning

confidence: 99%

“…Many other aspects of rhinoplasty, including reconstruction of saddle noses [77] and surgery of the nasal valve, nasal tip, and middle third of the nose, are currently not analysed in comparative prospective studies, although this is urgently required for the future development of rhinosurgery [75]. …”

Section: Types and Therapies Of Nasal Obstructionmentioning

confidence: 99%

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Evidence and evidence gaps in therapies of nasal obstruction and rhinosinusitis

Rotter¹

2016

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 15:Doc06

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Section: Types and Therapies Of Nasal Obstructionmentioning

confidence: 99%

Section: Types and Therapies Of Nasal Obstructionmentioning

confidence: 99%

Section: Types and Therapies Of Nasal Obstructionmentioning

confidence: 99%

Section: Types and Therapies Of Nasal Obstructionmentioning

confidence: 99%

See 2 more Smart Citations

Evidence and evidence gaps in therapies of nasal obstruction and rhinosinusitis

Rotter¹

2016

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 15:Doc06

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“…For nasal reconstruction the forehead is the gold standard due to the close colour match and subcutaneous thickness. The forearm skin flap can also be used if the forehead flap is unavailable [5, 6]. …”

Section: Introductionmentioning

confidence: 99%

Comparison of the mechanical properties of different skin sites for auricular and nasal reconstruction

Griffin

Leung

Premakumar

et al. 2017

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundAutologous and synthetic nasal and auricular frameworks require skin coverage. The surgeon’s decides on the appropriate skin coverage for reconstruction based on colour matching, subcutaneous tissue thickness, expertise and experience. One of the major complications of placing subcutaneous implants is the risk of extrusion (migration through the skin) and infection. However, knowledge of lessening the differential between the soft tissue and the framework can have important implications for extrusion. This study compared the mechanical properties of the skin commonly used as skin sites for the coverage in auricular and nasal reconstruction.MethodsUsing ten fresh human cadavers, the tensile Young’s Modulus of the skin from the forehead, forearm, temporoparietal, post-auricular and submandibular neck was assessed. The relaxation rate and absolute relaxation level was also assessed after 90 min of relaxation.ResultsThe submandibular skin showed the greatest Young’s elastic modulus in tension of all regions (1.28 MPa ±0.06) and forearm showed the lowest (1.03 MPa ±0.06). The forehead demonstrated greater relaxation rates among the different skin regions (7.8 MPa−07 ± 0.1). The forearm showed the lowest rate of relaxation (4.74 MPa−07 ± 0.1). The forearm (0.04 MPa ±0.004) and submandibular neck skin (0.04 MPa ±0.005) showed similar absolute levels of relaxation, which were significantly greater than the other skin regions (p < 0.05).ConclusionsThis study provides an understanding into the biomechanical properties of the skin of different sites allowing surgeons to consider this parameter when trying to identify the optimal skin coverage in nasal and auricular reconstruction.Electronic supplementary materialThe online version of this article (doi:10.1186/s40463-017-0210-6) contains supplementary material, which is available to authorized users.

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