The Relation Between the Lower Lateral Cartilages and the Function of the External Nasal Valve

Silva, Eduardo Nascimento

doi:10.1007/s00266-018-1195-x

Cited by 11 publications

(11 citation statements)

References 34 publications

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“…21 In another study on 60 patients in Brazil, 38% had LCCM. 5 The frequency of cephalic malposition in our study was lower than the percentage reported in previous studies (31.3%), which could be due to a larger patient population and Caucasian ethnicity. Overall, LCCM is overdiagnosed via 2D photography and its frequency was lower than expected in our study.…”

Section: Discussioncontrasting

confidence: 87%

“…3 Furthermore, the contribution of LCCM to functional disturbances of external nasal valves has been shown. [4][5][6] Contouring and shadows of the nose define different nasal structures. 7 Shadows of the nasal tip frame the domal structure, and LCCM causes the irregularity of tip contour, resulting in abnormal fullness in the supratip area.…”

mentioning

confidence: 99%

“…3 Furthermore, the contribution of LCCM to functional disturbances of external nasal valves has been shown. 4 5 6…”

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confidence: 99%

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Inaccuracy of Standard 2D Photography for the Diagnosis of Cephalic Malposition of Lateral Crural Cartilages

2021

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Lateral crural cephalic malposition (LCCM) is a well-known deformity of the nasal tip which contributes to functional disturbances of the external nasal valve. Accurate diagnosis of this deformity helps surgeons plan for better outcomes. A total of 176 candidate patients for primary rhinoplasty underwent standard 2D medical photography of the face. Senior authors analyzed photography results and differentiated the patients with LCCM. In addition, we measured the angle between the dorsal septum and lateral end of the long axis of the alar cartilage in the operation room. Ninety-five patients were diagnosed with LCCM on photography. As much as 31.3% (55) of all the patients had LCCM in intraoperative measurements. The sensitivity and specificity of 2D photography for diagnosing LCCM were 0.7924 and 0.5391, respectively. The main surgical techniques for correction of LCCM were alar repositioning (34.3% in total, 56% in LCCM patients) and lateral crural strut graft (43.8% in total, 69% in LCCM patients). LCCM is overdiagnosed via 2D photography, and this method lacks sensitivity. The overall frequency of LCCM seems to be lower than the previously reported frequency. For optimal results in rhinoplasty, surgeons must focus on the best contouring and function rather than solely correcting angles and rotations.

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confidence: 87%

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Inaccuracy of Standard 2D Photography for the Diagnosis of Cephalic Malposition of Lateral Crural Cartilages

2021

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“…Consequences of cephalic malposition were also discussed by Hamilton 56 and by Yeh and Williams EF, 57 who underlined the propensity of patients with cephalic malposition to NAO due to ENV impairment. According to Silva, 54 the alar contour void created by cephalic malposition should be addressed by structuring ENV walls. It would, thus, be expected that AARG or caudal repositioning of the lateral crura would have functional effect, by correcting this void.…”

Section: Discussionmentioning

confidence: 99%

“…53 This cephalic malposition has been demonstrated to cause ENV insufficiency. 54 Ilhan et al, 55 studying the long-term effects of caudal repositioning of the lateral crura, found both an esthetic and functional improvement, as assessed by ROE and by NOSE. Consequences of cephalic malposition were also discussed by Hamilton 56 and by Yeh and Williams EF, 57 who underlined the propensity of patients with cephalic malposition to NAO due to ENV impairment.…”

Section: Discussionmentioning

confidence: 99%

Comparative Functional Effect of Alternative Surgical Techniques Used in Rhinoplasty

Xavier

Azeredo‐Lopes

Menger

et al. 2022

Ann Otol Rhinol Laryngol

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Rhinoplasty makes use of a combination of surgical techniques selected to address the specific requirements of each individual nose. Several different surgical techniques may be used for addressing each section of the nose, with possible different functional effects. Objective: The purpose of this investigation is to compare the functional effect of the different surgical techniques used for addressing each section of the nose. Methods: Prospective study of 57 consecutive rhinoplasty patients. Patients were evaluated with peak nasal inspiratory flow (PNIF), Nasal Obstruction Symptom Evaluation (NOSE), and Visual Analog Scale (VAS) for nasal obstruction before and 1 year after rhinoplasty. Additionally, esthetic evaluation of the nose was obtained with Rhinoplasty Outcomes Evaluation (ROE). According to the surgical technique used to address each portion of the nose, groups of patients were created and the functional improvement of these groups was compared. Results: Using the TukeyHSD multiple pairwise-comparison test, the estimated difference of the increase of PNIF between using spreader grafts and using spreader flaps was 94.9 (95% CI 24.3, 165.5, P = .004) between spreader grafts and neither grafts or flaps was 79.2 (95% CI 5.8, 152.6, P = .03), between spreader grafts and bilateral spreader flaps plus a unilateral spreader graft was 90.2 (95% CI 22.1, 158.2, P = .005). In all other portions of the nose, no significant difference was found in the functional improvement between different surgical techniques. Conclusions: Spreader grafts increase PNIF more significantly than other surgical techniques used for dorsal mid-vault reconstruction. Spreader grafts should be preferred over other techniques whenever an improvement of nasal airflow is required. No significant differences were found between the functional effect of alternative techniques used in other sections of the nose. Additional cohort studies will be necessary to further confirm data from this investigation.

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Nasal Obstruction

Dilek,

Kar,

Bedrosian

2023

Airway Diseases

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The Relation Between the Lower Lateral Cartilages and the Function of the External Nasal Valve

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 11 publications

References 34 publications

Inaccuracy of Standard 2D Photography for the Diagnosis of Cephalic Malposition of Lateral Crural Cartilages

Inaccuracy of Standard 2D Photography for the Diagnosis of Cephalic Malposition of Lateral Crural Cartilages

Comparative Functional Effect of Alternative Surgical Techniques Used in Rhinoplasty

Nasal Obstruction

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