The Role of Outfracture in Correcting Post-Rhinoplasty Nasal Obstruction

Pontell, Jonathan; Slavit, David H.; Kern, Eugene B.

doi:10.1177/014556139807700209

Cited by 24 publications

(7 citation statements)

References 6 publications

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“…(REPRINTED) ARCH FACIAL PLAST SURG/ VOL 6, MAY/ JUNE 2004 tion in 72% of their patients. Pontell et al 6 reported that 10% of their rhinoplasty patients complained of nasal obstruction, which was attributed to the nasal valve region. Grymer 7 and Sheen 8 have shown that rhinoplasty causes internal valve narrowing in 25% of patients and external valve narrowing in 85% of patients.…”

Section: Resultsmentioning

confidence: 99%

Nasal Valve Reconstruction

Khosh

Jen

Honrado

et al. 2004

Archives of Facial Plastic Surgery

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To determine the cause of nasal valve obstruction in a series of patients requiring surgical correction, to evaluate the efficacy of our surgical techniques, and to assess the cosmetic effect of nasal valve repair. Methods: Retrospective review of 53 consecutive cases involving adult patients who underwent nasal valve reconstruction over an 8-year period. The preoperative symptom severity, cause of nasal valve obstruction, preoperative photographs, anatomical findings at the time of surgery, and reconstructive techniques were reviewed. Postoperative photographs and resolution of symptoms were analyzed. Results: The most common cause of nasal valve obstruction was previous rhinoplasty (79%), followed by nasal trauma (15%) and congenital anomaly (6%). Spreader grafts were used in 42 patients (79%), and alar batten grafts were

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Section: Resultsmentioning

confidence: 99%

Nasal Valve Reconstruction

Khosh

Jen

Honrado

et al. 2004

Archives of Facial Plastic Surgery

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“…Some cases of severe valvular stenosis following rhinoplasty require revision osteotomies with outfracture of the nasal bones. 51…”

Section: Discussionmentioning

confidence: 99%

Nasal Valves-Importance and Surgical Procedures

Fischer

Gubisch

2006

Facial plast Surg

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One of the most difficult aspects in rhinoplasty is resolving and preventing functional compromise of the nasal valve area reliably. The nasal valves are crucial for the individual breathing competence of the nose. Structural and functional elements contribute to this complex system: the nasolabial angle, the configuration and stability of the alae, the function of the internal nasal valve, the anterior septum symmetrically separating the bilateral airways and giving structural and functional support to the alar cartilage complex and to their junction with the upper lateral cartilages, the scroll area. Subsequently, the open angle between septum and sidewalls is important for sufficient airflow as well as the position and function of the head of the turbinates. The clinical examination of these elements is described. Surgical techniques are more or less well known and demonstrated with patient examples and drawings: anterior septoplasty, reconstruction of tip and dorsum support by septal extension grafts and septal replacement, tip suspension and lateral crural sliding technique, spreader grafts and suture techniques, splay grafts, alar batten grafts, lateral crural extension grafts, and lateral alar suspension. The numerous literature is reviewed.

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“…These maneuvers have been shown to increase the cross-sectional area with proper patient selection. 17 Less frequently, the bony pyriform aperture can be drilled open through the sublabial route. Again, intranasal packing would be needed for at least 1 week.…”

Section: The Internal Nasal Valvementioning

confidence: 99%

Functional Considerations in Revision Rhinoplasty

Ballert

Park

2008

Facial plast Surg

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The development of nasal obstruction after rhinoplasty is associated with significant patient dissatisfaction. Correction of nasal obstruction requires a thorough evaluation to determine the ANATOMIC EPICENTER of obstruction. The offending structure can usually be traced to abnormalities in the internal nasal valve, intervalve area, or the external nasal valve and may be static or dynamic. Surgical correction of the internal nasal valve using spreader grafts, flaring sutures, and butterfly grafts has been shown to increase the cross-sectional area of this nasal valve, improving nasal airflow and patient satisfaction. External valve dysfunction from cicatricial stenosis may be addressed with local flaps; however, larger stenoses may require composite grafts. Alar base malposition can be addressed by repositioning of the alar base with local island flaps. Intervalve dysfunction involves the important area between the external and internal valves, under the supra-alar crease, and is the most common site of obstruction. Its correction often involves alar batten grafts and reconstruction of the lateral crura. Inferior turbinate hypertrophy and concha bullosa may be addressed as adjunctive therapy to increase nasal airflow. This article on nasal obstruction after rhinoplasty emphasizes the precise anatomic diagnosis and describes successful methods used to correct the dysfunction.

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The Role of Outfracture in Correcting Post-Rhinoplasty Nasal Obstruction

Cited by 24 publications

References 6 publications

Nasal Valve Reconstruction

Nasal Valve Reconstruction

Nasal Valves-Importance and Surgical Procedures

Functional Considerations in Revision Rhinoplasty

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