1/54. A case of reconstruction of saddle nose deformity in leprosy.A case of reconstructive surgery for saddle nose deformity is presented in this paper. A 22 year-old Bengali female who had completed WHO/MB regimen for 27 months underwent reconstructive surgery for saddle nose deformity. Since a saddle nose is one of the symbols of leprosy, it often causes serious psychological and social troubles to patients. This happens more often when the patient is a young unmarried woman. In this case the saddle nose seemed to be very serious. After being discharged from hospital she got married and had a baby. This operation gave the patient great relief to live in the community, because she no longer had serious visible evidence of leprosy on the body. Though the correction of the deformity without any dysfunction does not always have priority over other surgeries at a busy leprosy control project in bangladesh, it has merit both in patients themselves and in the society around them because it leads to the elimination of the stigma of leprosy.- - - - - - - - - - ranking = 1keywords = deformity (Clic here for more details about this article) |
2/54. Alar haematoma.We present two cases of alar haematoma. This is a very rare complication of nasal trauma, and only two cases have been described previously. One case presented late and did not undergo surgical drainage and has a persistent cosmetic deformity. We recommend early surgical drainage when possible.- - - - - - - - - - ranking = 0.14285714285714keywords = deformity (Clic here for more details about this article) |
3/54. Nasal angiocentric lymphoma: an entity that should be remembered.After four nasal aesthetic functional surgeries in a period of 18 months, a 46-year-old woman was evaluated who presented with moderate functional alteration, saddle-nose deformity, and total loss of the septal cartilage. Four months before presentation the patient sustained severe nasal trauma, resulting in depression of the nasal bridge without loss of function. Her problem was diagnosed initially as a consequence of an infected septal hematoma and loss of the septal cartilage. Based on this diagnosis, the patient was subjected, in an 18-month period, to four reconstructive surgeries by different specialists, without any improvement and with worsening of clinical presentation. During the authors' physical examination of the patient, she demonstrated marked nasal cutaneous retraction, atrophic nasal conchae with total loss of the septal cartilage, and a large loss of septal bone. Three nasal mucosa biopsies were acquired and the authors proceeded to carry out complete nasal reconstruction using external cranial table and rib cartilage. Histopathologically, a lesion was noted that was compatible with angiocentric lymphoma, for which treatment was administered according to this type of illness. The authors point out the importance of establishing an adequate diagnosis in the face of an apparently obvious clinical case, present cross-disciplinary treatment, and discuss the study protocol that should be used for this type of pathology. They present their reconstructive technique of the nasal structure using a combination of bone tissue and cartilage, the results, and the current state of the patient.- - - - - - - - - - ranking = 0.14285714285714keywords = deformity (Clic here for more details about this article) |
4/54. osteotomy techniques to correct posttraumatic deviation of the nasal pyramid: a technical note.BACKGROUND AND OBJECTIVES: Correction of the deviated nasal pyramid is frequently incomplete and may result in a sub-optimal surgical outcome. Precise anatomic analysis of the deformity and a thorough understanding of available techniques improve the surgical osteotomy. methods AND MATERIALS: The advantages and disadvantages of the various osteotomy techniques are analyzed, based on the cadaver studies and clinical experience of the authors. The cadaver studies demonstrate the anatomic results when various osteotomes are used in specified ways. Clinical outcomes in the treatment of posttraumatic nose deviations correlate well with these results. RESULTS AND/OR CONCLUSIONS: A thorough understanding of the advantages and disadvantages of various osteotomy techniques enables the surgeon to apply them to specific anatomical deformities in posttraumatic nose deviations more precisely. In general, perforating osteotomies preserve more soft tissue support than the linear osteotomies. Sequential osteotomies, occasionally combined with intermediate osteotomies, are useful in straightening the extremely deviated nasal pyramid.- - - - - - - - - - ranking = 0.14285714285714keywords = deformity (Clic here for more details about this article) |
5/54. Correction of severe secondary cleft lip nasal deformity using a composite graft: current approach and review.In the case of a severe tissue deficiency with a secondary cleft lip nasal deformity, a composite graft can be useful for columellar lengthening or to create symmetrical nostrils. The current study used composite grafts to correct secondary cleft lip nasal deformities with a severe tissue deficiency or severe nostril asymmetry. A total of 19 patients who were born with complete cleft type were operated between 1995 and 1999. Of these patients, 10 were men and 9 were women, and the age distribution was 7 to 35 years old. In 9 patients with unilateral cleft lip nasal deformities and in 6 patients with bilateral cleft lip nasal deformities, columellar lengthening was performed using a composite graft taken from the helix in 14 patients and the contralateral alar rim in 1 patient. In 4 patients with severely asymmetrical nostrils resulting from a short alar rim in unilateral cleft lip nasal deformities, the ear helix was used in 2 patients, whereas in the other two patients, the alar rim of the unaffected side was transferred to the affected side to create a symmetrical nostril by reducing the length of the ala on the unaffected side. The follow-up period ranged from 1 to 3 years, and results were as follows: Four days after the graft, the composite tissue exhibited a pinkish color, and complete survival was confirmed after 7 days. The absorption rate was approximately 10% and the color mismatch became minimal with time. Composite tissue from the ear was found to be useful for full-layer reconstruction of the ala and columella because of its stiffness, thin nature, and similarity. Composite tissue from the alar rim on the contralateral side was also determined to be a good material for full-layer reconstruction of the deficient ala.- - - - - - - - - - ranking = 0.71428571428571keywords = deformity (Clic here for more details about this article) |
6/54. The frontonasal flap for increased exposure in posttraumatic nasal deformity: a technical overview.Nasal reconstruction continues to be a surgical challenge. The prominent location of the nose, the unique quality and texture of its skin, and the intricacies of its cartilaginous and bony infrastructure demand careful attention to fine detail. Attempts to refine reconstructive techniques have resulted in a myriad of local flaps. The frontonasal flap is well-described and reliable, but it is infrequently used. A brief review of the literature is presented. The authors describe a unique case of a 64-year-old woman with posttraumatic nasal tip and dorsal deformity. The frontonasal flap provided soft tissue coverage for the nasal tip and allowed excellent exposure for reconstruction of the hard nasal framework with cartilage and bone grafts. It provides local tissue with excellent contour, color, and texture match, and can be performed in one stage.- - - - - - - - - - ranking = 0.71428571428571keywords = deformity (Clic here for more details about this article) |
7/54. External rhinoplasty approach for repair of posttraumatic nasal deformity.Up to 50% of patients who have suffered a nasal fracture may seek reconstructive surgery because they are dissatisfied with their appearance and/or ability to breathe. Distortion of native anatomy and dissection planes increases with severity of the injury. The external rhinoplasty approach is a biologically sound technique that offers several advantages over endonasal access for the repair of complex nasal deformities. In 30 consecutive posttraumatic rhinoplasty cases over a 2-year period, 27 (90%) patients underwent correction of their deformities via the external rhinoplasty approach. No technique-specific sequelae were encountered, and all patients were satisfied with their respective result and the healing of the transcolumellar incision. This article reviews the advantages, disadvantages, and contraindications of the external rhinoplasty approach in the posttraumatic patient.- - - - - - - - - - ranking = 0.57142857142857keywords = deformity (Clic here for more details about this article) |
8/54. The traumatic saddle nose deformity: etiology and treatment.The saddle nose resembles a saddle, i.e., with a concave, often flattened dorsum and an apparent cephalic rotation of the nasal tip. The concavity may be present in the osseous or cartilaginous dorsum, or both. The saddle nose deformity can be divided into congenital, postinfection, postsurgical, and traumatic types. Congenital saddle nose deformity is rare, often accompanying midfacial deficiency malformation syndromes. The advent of antimicrobial therapy has helped restrict the incidence of syphilitic or leprotic saddle nose to the nonindustrialized nations. Postsurgical saddle nose deformity occurs most often as a result of the overzealous septorhinoplasty. The most common type of saddle nose deformity may be traumatic. The authors use Kazanjian and Converse's characterization of the true saddle nose as one in which the bony and/or cartilaginous portions are depressed and the projection of the nose is generally preserved. This article describes the saddle nose deformity and its etiology and proposes a management technique with minimal complications.- - - - - - - - - - ranking = 1.2857142857143keywords = deformity (Clic here for more details about this article) |
9/54. cocaine-induced oronasal fistulas with external nasal erosion but without palate involvement.The effects of chronic cocaine abuse have been widely described in the literature. Common complications include nasal septal perforation, saddle-nose deformity, and palatal perforation. Erosion of the external structures of the face has not been as extensively described, nor have oronasal fistulas that involve structures other than the hard or soft palate. In this article, we present the first reported case of cocaine-induced external nasal erosion that included multiple oronasal fistulas in the anterior gingival sulcus but did not involve the hard or soft palate. We stress the importance of a thorough history in such patients and consideration of all possible diagnoses, including drug abuse.- - - - - - - - - - ranking = 0.14285714285714keywords = deformity (Clic here for more details about this article) |
10/54. The use of lower turbinate bone grafts in the treatment of saddle nose deformities.Saddle nose reconstruction is based on the use of support grafts to manage aesthetic and functional problems. Bone (calvarial, iliac crest, costal, nasal hump, ulnar, and heterogeneous origin), cartilage (septal, costal, heterogeneous), and synthetic materials (silicon, silastic, polyethylene) were used as support grafts. Three patients have been included in this study to define the surgical management and long-term aesthetic and functional results of patients undergoing rhinoplasty with support grafts for a saddle nose deformity. Open rhinoplasty was employed. Both the lower turbinates were excised and the bone dissected from the soft tissues in two cases and in one case, only mucosa was removed. The amount of support needed was measured by using bone wax. The bone was used shaped in layers, according to the defect, and sutured to each other by vycril suture, and wrapped around by surgicell. The graft was then inserted in its place and fixed with external prolene sutures. Results were satisfactory in both function and aesthetics. Ten to 16-month follow-ups had no complications. Saddle nose surgery basically requires the use of a support graft to repair the nasal dorsum. A lower turbinate bone graft procedure has some advantages: it is cheap and safe, it is ready to use and not time-consuming, there is no donor area and no additional donor site morbidity, and it enlarges the airway and the passage to prevent nasal airway obstruction.- - - - - - - - - - ranking = 0.14285714285714keywords = deformity (Clic here for more details about this article) |
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