Journal Article•
Corrective surgery of the external nasal pyramid and the nasal septum for restoration of normal physiology.
About: This article is published in Illinois medical journal.The article was published on 1946-08-01 and is currently open access. It has received 53 citations till now. The article focuses on the topics: Nasal septum & Pyramid.
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TL;DR: The senior author's current operative technique for dorsal preservation in reduction rhinoplasty based on 320 clinical cases performed over a 5-year period is presented, with results in more natural postoperative dorsum lines and a "not operated" aspect without the need for midvault reconstruction.
179 citations
TL;DR: This subject cannot be considered closed because of the question of complications that sometimes follow hump removal and the Question of the function of the dorsum of the nose.
Abstract: A CONVEX prominence of the dorsum of the nose is referred to as a hump. The term "hump" implies an undesirable projection, and its removal and disposal would therefore appear desirable. Humps are surgically removed for cosmetic reasons by a variety of techniques, all of which follow essentially the principles originally described by Joseph 1 at the beginning of the century. The use of the saw, the chisel, and the biting forceps has been extensively investigated in this connection, but regardless of the method of removal chosen, the surgeon has wished to do away with the hump effectively. This would conclude the discussion, leaving only the choice of patient and method of procedure to be decided; but there are two reasons why this subject cannot be considered closed: (1) the question of complications that sometimes follow hump removal and (2) the question of the function of the dorsum of the
97 citations
03 Mar 2020
TL;DR: An understanding of the potential benefits, techniques, and challenges associated with dorsal preservation (DP) techniques is helpful, and critical assessment of patient-reported outcomes and objective nasal measurements will be valuable.
Abstract: Importance: Although conventional hump resections are a hallmark of rhinoplasty, there has been a rekindled interest in dorsal preservation (DP) techniques as a means for addressing the dorsal hump, with claims of superior functional and aesthetic results. As such, an understanding of DP, including technical considerations and outcomes, is imperative. Observations: DP allows for mobilization of the osseocartilaginous nasal vault as a single unit and thereby prevents disruption of the natural keystone area. The osseous nasal vault is managed with a transverse osteotomy and either a bilateral single lateral osteotomy (pushdown procedure) or bilateral bony wedge resections (letdown procedure) to allow for descent of the nasal dorsum. A variety of approaches to the septum exist, each differentiated by the location of cartilage resection: subdorsal, high-septal, midseptal, or inferior septum. These techniques result in pleasing dorsal aesthetic lines but may be limited by a higher rate of dorsal hump recurrence. Patency of the internal nasal valve (INV) is theoretically improved with DP. Robust series with patient-reported outcomes are lacking, although several reports and early experience at our center with a newly described high-septal resection technique do suggest positive functional and cosmetic outcomes with DP. Conclusions and Relevance: With the recent revitalized interest in DP, an understanding of the potential benefits, techniques, and challenges associated with this surgery is helpful. Maintenance of the dorsum as a single unit has implications for maintaining structural integrity at the nasal keystone, pleasing dorsal aesthetic lines, and the patency of the INV. As surgeons continue to develop and employ these techniques, critical assessment of patient-reported outcomes and objective nasal measurements, with an emphasis on comparison with standard hump takedown techniques, will be valuable.
73 citations
TL;DR: The spare roof technique (SRT) is the first technique that is based on a complete skeletonization/preservation of the upper lateral cartilages and it is also very useful in the classical humpectomy of the Caucasian nose and correction of the crooked nose.
Abstract: To our knowledge, the spare roof technique (SRT) is the first technique that is based on a complete skeletonization/preservation of the upper lateral cartilages. This technique is used to keep the natural roof of the nose's middle third, while dehumping and/or correcting the crooked septum. From January 2014 till March 2015, a total of 40 rhinoplasties were performed through the SRT: 28 reduction rhinoplasties, 6 complex crooked noses (with extracorporeal septoplasty), and 6 mixed cases. The SRT is an excellent middle third technique. The natural roof was kept and fitted the accurate new position in almost all cases with no surgical complexity. It is an easy technique with many applications and it is also very useful in the classical humpectomy of the Caucasian nose and correction of the crooked nose.
67 citations
TL;DR: More patients were satisfied with the functional results after septoplasty, which also resulted in fewer and smaller perforations than SMR, and Septoplasty ought to replace the latter as the routine procedure.
Abstract: Information obtained from the case-records and completed questionnaires from 478 patients operated in the 5-year-period 1980 through 1984 with either septoplasty or submucous resection (SMR), has been analysed on an average 31 months after surgery. Two hundred (42 per cent) underwent SMR and 278 (58 per cent) septoplasty. Twenty per cent presented for a clinical follow-up examination. Of the 478 patients, 63 per cent were satisfied. More patients were satisfied with the functional results after septoplasty, which also resulted in fewer and smaller perforations than SMR. Septoplasty ought to replace the latter as the routine procedure. 10 per cent had troublesome crusting independent of the technique used. Change in the external shape of the nose is a minor problem for the patients, and was not regarded as an indication for re-operation. Patients with allergic rhinitis may undergo septal surgery on general lines.
66 citations