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Published in: European Journal of Plastic Surgery 2/2019

01-04-2019 | Original Paper

Esthetic and functional result of crooked nose treatment; internal microperforating osteotomy and subtotal septal reconstruction

Author: Hadi Nural

Published in: European Journal of Plastic Surgery | Issue 2/2019

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Abstract

Crooked nose is mostly characterized by a deviation of both the bone and the cartilaginous parts of the nose. In order to obtain proper functional and improved esthetic results, both of these parts have to be corrected. The objective of this study is to evaluate the esthetical and the functional outcomes following correction procedures of the bone pyramid through internal microperforating technique and the cartilaginous part through subtotal septal reconstruction. The medical records of 158 patients who have undergone through primary septorhinoplasty for crooked nose treatment during the period of 21 June 2016 and 31 July 2017 have been reviewed. Functional results have been evaluated using the Nasal Obstruction Symptom Evaluation (NOSE) scores and the esthetical results through Rhinoplasty Outcome Evaluation (ROE) scores. The observation times have been arranged preoperatively as 6 months–1 year (group 1) and 1–2 years (group 2). Septorhinoplasty procedure has been performed on 158 patients with crooked noses. Out of this number, 104 of the patients (65.8%) were women and 54 were men (34.2%). The average age of the patients was 31.59 (9.3%), all of who have undergone this procedure. There was a significant improvement (P < 0.001) in the NOSE and the ROE scores of group 1 and group 2, which was statistically significant. There was no difference between group 1 and group 2. In crooked nose treatment, correction of the deviated bone pyramid using internal microperforating osteotomy and correction of the severely deviated septum using subtotal septal reconstruction yield improved functional and esthetic results.
Level of Evidence: Level V, therapeutic study.
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Literature
1.
go back to reference Gerbault O, Daniel RK, Kosins AM (2016) The role of piezoelectric instrumentation in rhinoplasty surgery. Aesthet Surg J 361:21–34 Google ScholarCrossRefPubMedCrossRef Gerbault O, Daniel RK, Kosins AM (2016) The role of piezoelectric instrumentation in rhinoplasty surgery. Aesthet Surg J 361:21–34 Google ScholarCrossRefPubMedCrossRef
2.
go back to reference Gubisch W (2005) Extracorporeal septoplasty for the markedly deviated septum. Arch Facial Plast Surg 7(4):218–226CrossRefPubMed Gubisch W (2005) Extracorporeal septoplasty for the markedly deviated septum. Arch Facial Plast Surg 7(4):218–226CrossRefPubMed
3.
go back to reference Most SP (2006) Anterior septal reconstruction: outcomes after a modified extracorporeal septoplasty technique. Arch Facial Plast Surg 8(3):202–207CrossRefPubMed Most SP (2006) Anterior septal reconstruction: outcomes after a modified extracorporeal septoplasty technique. Arch Facial Plast Surg 8(3):202–207CrossRefPubMed
4.
go back to reference Toriumi DM (1994) Subtotal reconstruction of the nasal septum: a preliminary report. Laryngoscope 104(7):906–913CrossRefPubMed Toriumi DM (1994) Subtotal reconstruction of the nasal septum: a preliminary report. Laryngoscope 104(7):906–913CrossRefPubMed
5.
go back to reference Ross Mobley S, Long J (2016) Extracorporeal septoplasty: assessing functional outcomes using the validated Nasal Obstruction Symptom Evaluation score over a 3-year period. Plast Reconstr Surg 137(1):151e–163eCrossRefPubMed Ross Mobley S, Long J (2016) Extracorporeal septoplasty: assessing functional outcomes using the validated Nasal Obstruction Symptom Evaluation score over a 3-year period. Plast Reconstr Surg 137(1):151e–163eCrossRefPubMed
6.
go back to reference Russell WH, Kridel MD, Bruce A, Scott MD, Hossam MT, Foda MD (1999) The Tongue-in-Groove Technique in septorhinoplasty: a 10-year experience. Arch Facial Plast Surg 1(4):246–256CrossRef Russell WH, Kridel MD, Bruce A, Scott MD, Hossam MT, Foda MD (1999) The Tongue-in-Groove Technique in septorhinoplasty: a 10-year experience. Arch Facial Plast Surg 1(4):246–256CrossRef
7.
go back to reference Mau T, Mau ST, Kim DW (2007) Cadaveric and engineering analysis of the septal L-strut. Laryngoscope 117(11):1902–1906CrossRefPubMed Mau T, Mau ST, Kim DW (2007) Cadaveric and engineering analysis of the septal L-strut. Laryngoscope 117(11):1902–1906CrossRefPubMed
8.
go back to reference Lee SJ, Liong K, Lee HP (2010) Deformation of nasal septum during nasal trauma. Laryngoscope 120(10):1931–1939CrossRefPubMed Lee SJ, Liong K, Lee HP (2010) Deformation of nasal septum during nasal trauma. Laryngoscope 120(10):1931–1939CrossRefPubMed
9.
go back to reference Alsarraf R (2000) Outcomes research in facial plastic surgery: a review and new directions. Aesthet Plast Surg 24(3):192–197CrossRef Alsarraf R (2000) Outcomes research in facial plastic surgery: a review and new directions. Aesthet Plast Surg 24(3):192–197CrossRef
10.
go back to reference Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT (2004) Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg. 130(2):157–163CrossRefPubMed Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT (2004) Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg. 130(2):157–163CrossRefPubMed
11.
go back to reference Stewart MG, Smith TL, Weaver EM et al (2004) Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg 130(3):283–290CrossRefPubMed Stewart MG, Smith TL, Weaver EM et al (2004) Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg 130(3):283–290CrossRefPubMed
12.
go back to reference King ED, Ashley FL (1952) The correction of the internally and externally deviated nose. Plast Reconstr Surg (1946) 10(2):116–120CrossRef King ED, Ashley FL (1952) The correction of the internally and externally deviated nose. Plast Reconstr Surg (1946) 10(2):116–120CrossRef
13.
go back to reference Gubisch W (1995) The extracorporeal septum plasty: a technique to correct difficult nasal deformities. Plast Reconstr Surg 95:672–682CrossRefPubMed Gubisch W (1995) The extracorporeal septum plasty: a technique to correct difficult nasal deformities. Plast Reconstr Surg 95:672–682CrossRefPubMed
14.
go back to reference Çakır B, Öreroğlu AR, Doğan T, Akan M (2012) A complete subperichondrial dissection technique for rhinoplasty with management of the nasal ligaments. Aesthet Surg J 32(5):564–574CrossRefPubMed Çakır B, Öreroğlu AR, Doğan T, Akan M (2012) A complete subperichondrial dissection technique for rhinoplasty with management of the nasal ligaments. Aesthet Surg J 32(5):564–574CrossRefPubMed
15.
go back to reference Gabra N, Rahal A, Ahmarani C (2014) Nasal osteotomies: a cadaveric study of fracture lines. JAMA Facial Plast Surg 16(4):268–271CrossRefPubMed Gabra N, Rahal A, Ahmarani C (2014) Nasal osteotomies: a cadaveric study of fracture lines. JAMA Facial Plast Surg 16(4):268–271CrossRefPubMed
16.
go back to reference Paul N, Messinger K, Liu YF, Kwon DI, Kim CH, Inman JC (2016) A model to estimate L-strut strength with an emphasis on thickness. JAMA Facial Plast Surg 18(4):269–276CrossRefPubMed Paul N, Messinger K, Liu YF, Kwon DI, Kim CH, Inman JC (2016) A model to estimate L-strut strength with an emphasis on thickness. JAMA Facial Plast Surg 18(4):269–276CrossRefPubMed
17.
go back to reference Yuan F, Liu MD, Kelton Messinger BS, Jared C, Inman MD (2017) Yield strength testing in human cadaver nasal septal cartilage and L-strut constructs. JAMA Facial Plast Surg 19(1):40–45CrossRef Yuan F, Liu MD, Kelton Messinger BS, Jared C, Inman MD (2017) Yield strength testing in human cadaver nasal septal cartilage and L-strut constructs. JAMA Facial Plast Surg 19(1):40–45CrossRef
18.
go back to reference Surowitz J, Lee MK, Most SP (2015) Anterior septal reconstruction for treatment of severe caudal septal deviation: clinical severity and outcomes. Otolaryngol Head Neck Surg 153(1):27–33CrossRefPubMed Surowitz J, Lee MK, Most SP (2015) Anterior septal reconstruction for treatment of severe caudal septal deviation: clinical severity and outcomes. Otolaryngol Head Neck Surg 153(1):27–33CrossRefPubMed
19.
go back to reference Asher SA, Kakodkar AS, Toriumi DM (2018) Long-term outcomes of subtotal septal reconstruction in rhinoplasty. JAMA Facial Plast Surg 20(1):50–56CrossRefPubMed Asher SA, Kakodkar AS, Toriumi DM (2018) Long-term outcomes of subtotal septal reconstruction in rhinoplasty. JAMA Facial Plast Surg 20(1):50–56CrossRefPubMed
20.
go back to reference Spataro E, Piccirillo JF, Kallogjeri D et al (2016) Revision rates and risk factors of 175 842 patients undergoing septorhinoplasty. JAMA Facial Plast Surg 18(3):212–219CrossRefPubMedPubMedCentral Spataro E, Piccirillo JF, Kallogjeri D et al (2016) Revision rates and risk factors of 175 842 patients undergoing septorhinoplasty. JAMA Facial Plast Surg 18(3):212–219CrossRefPubMedPubMedCentral
21.
go back to reference Constantian MB (2005) The boxy nasal tip, the ball tip, and alar cartilage malposition: variations on a theme: a study in 200 consecutive primary and secondary rhinoplasty patients. Plast Reconstr Surg 116(1):268–281CrossRefPubMed Constantian MB (2005) The boxy nasal tip, the ball tip, and alar cartilage malposition: variations on a theme: a study in 200 consecutive primary and secondary rhinoplasty patients. Plast Reconstr Surg 116(1):268–281CrossRefPubMed
22.
go back to reference Gunter JP, Friedman RM (1997) Lateral crural strut graft: technique and clinical applications in rhinoplasty. Plast Reconstr Surg 99(4):943–952CrossRefPubMed Gunter JP, Friedman RM (1997) Lateral crural strut graft: technique and clinical applications in rhinoplasty. Plast Reconstr Surg 99(4):943–952CrossRefPubMed
23.
go back to reference Toriumi DM, Asher SA (2015) Lateral crural repositioning for treatment of cephalic malposition. Facial Plast Surg Clin North Am 23(1):55–71CrossRefPubMed Toriumi DM, Asher SA (2015) Lateral crural repositioning for treatment of cephalic malposition. Facial Plast Surg Clin North Am 23(1):55–71CrossRefPubMed
24.
go back to reference Sheen JH (1978) Aesthetic rhinoplasty. Mosby–Year Book Inc, St Louis Sheen JH (1978) Aesthetic rhinoplasty. Mosby–Year Book Inc, St Louis
25.
go back to reference Ilhan AE, Saribas B, Caypinar B (2015) Aesthetic and functional results of lateral crural repositioning. JAMA Facial Plast Surg 17(4):286–292CrossRefPubMed Ilhan AE, Saribas B, Caypinar B (2015) Aesthetic and functional results of lateral crural repositioning. JAMA Facial Plast Surg 17(4):286–292CrossRefPubMed
26.
go back to reference AF K, Cano SJ, East CA et al (2016) Development and psychometric evaluation of the FACE-Q scales for patients undergoing rhinoplasty. JAMA Facial Plast Surg. 18(1):27–35CrossRef AF K, Cano SJ, East CA et al (2016) Development and psychometric evaluation of the FACE-Q scales for patients undergoing rhinoplasty. JAMA Facial Plast Surg. 18(1):27–35CrossRef
27.
go back to reference Lee MK, Most SP (2016) A comprehensive quality-of-life instrument for aesthetic and functional rhinoplasty: the RHINO scale. Plast Reconstr Surg Glob Open 4(2):e611CrossRefPubMedPubMedCentral Lee MK, Most SP (2016) A comprehensive quality-of-life instrument for aesthetic and functional rhinoplasty: the RHINO scale. Plast Reconstr Surg Glob Open 4(2):e611CrossRefPubMedPubMedCentral
28.
go back to reference Barone M, Cogliandro A, Di Stefano N, Tambone V, Persichetti P (2017) A systematic review of patient-reported outcome measures after rhinoplasty. Eur Arch Otorhinolaryngol 274(4):1807–1811CrossRefPubMed Barone M, Cogliandro A, Di Stefano N, Tambone V, Persichetti P (2017) A systematic review of patient-reported outcome measures after rhinoplasty. Eur Arch Otorhinolaryngol 274(4):1807–1811CrossRefPubMed
29.
go back to reference Byrne M, Chan JC, O’Broin E (2014) Perceptions and satisfaction of aesthetic outcome following secondary cleft rhinoplasty: evaluation by patients versus health professionals. J Craniomaxillofac Surg 42:1062–1070CrossRefPubMed Byrne M, Chan JC, O’Broin E (2014) Perceptions and satisfaction of aesthetic outcome following secondary cleft rhinoplasty: evaluation by patients versus health professionals. J Craniomaxillofac Surg 42:1062–1070CrossRefPubMed
Metadata
Title
Esthetic and functional result of crooked nose treatment; internal microperforating osteotomy and subtotal septal reconstruction
Author
Hadi Nural
Publication date
01-04-2019
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Plastic Surgery / Issue 2/2019
Print ISSN: 0930-343X
Electronic ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-018-1469-1

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