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Functional Rhinoplasty, An Issue of Facial Plastic Surgery Clinics of North America, E-Book

Functional Rhinoplasty, An Issue of Facial Plastic Surgery Clinics of North America, E-Book

Benjamin C. Marcus

(2017)

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Book Details

Abstract

This issue of Facial Plastic Surgery Clinics, guest edited by Dr. Benjamin C. Marcus, is devoted to Functional Rhinoplasty. Articles in this outstanding issue include: Essential Anatomy and Evaluation for Functional Rhinoplasty; Septoplasty: Basic and Advanced Techniques; The Role of the Inferior Turbinate in Rhinoplasty; The External Nasal Valve; The Internal Valve: Dynamic and Static Repairs; The Art of Osteotomies; Repair of Nasal Septum Perforations; Management of Pediatric Rhinoplasty; Cleft Septorhinoplasty: Form and Function; The Saddle Deformity: Camouflage and Reconstruction; Revision Functional Surgery: Salvaging Function; and Advances in Technology for Functional Rhinoplasty.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Functional Rhinoplasty i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents v
Preface: Crafting a Functional Nose v
Essential Anatomy and Evaluation for Functional Rhinoplasty v
Septoplasty: Basic and Advanced Techniques v
The Inferior Turbinate in Rhinoplasty v
The External Nasal Valve v
Functional Rhinoplasty vi
Osteotomies Demystified vi
Management of Pediatric Nasal Surgery (Rhinoplasty) vi
Cleft Septorhinoplasty: Form and Function vi
The Saddle Deformity: Camouflage and Reconstruction vi
Revision Functional Surgery: Salvaging Function vii
Advances in Technology for Functional Rhinoplasty: The Next Frontier vii
FACIAL PLASTIC SURGERY CLINICS\rOF NORTH AMERICA\r viii
FORTHCOMING ISSUES viii
August 2017 viii
November 2017 viii
February 2018 viii
RECENT ISSUES viii
February 2017 viii
November 2016 viii
August 2016 viii
Preface:\rCrafting a Functional Nose ix
Essential Anatomy and Evaluation for Functional Rhinoplasty 141
Key points 141
INTRODUCTION 141
FUNCTIONAL ANATOMY 142
Bony Pyramid 142
Cartilaginous Pyramid 142
Lower Lateral Cartilages 143
Lobule 143
The Nasal Valves 143
External Nasal Valve 144
Internal Nasal Valve 144
Inferior Turbinates 145
Skin and Soft Tissue Envelope 146
Muscles 147
Blood Supply 147
Nerves 148
PATIENT EVALUATION 149
Subjective Evaluation 149
Nasal-facial analysis 149
Quality of life measures 152
Nasal Obstruction Symptom Evaluation 152
Visual analog scale 154
Palpation 154
Cottle and modified Cottle maneuvers 155
Intranasal examination: anterior rhinoscopy and endoscopy 156
Photoanalysis 156
OBJECTIVE MEASUREMENTS OF NASAL OBSTRUCTION 156
Rhinomanometry 156
Acoustic Rhinometry 157
Imaging Studies 157
Rhinoresiliography 158
SUMMARY 158
REFERENCES 158
Septoplasty\rBasic and Advanced Techniques\r 161
Key points 161
INTRODUCTION 161
SEPTAL ANATOMY 161
Important Surrounding Structures 162
PREOPERATIVE CONSIDERATIONS 162
Surgical Indications 162
Preoperative Workup 162
Preoperative Physical Examination 163
SURGICAL TECHNIQUE 163
Standard Endonasal Septoplasty Procedure Outlined 163
ANTERIOR SEPTAL DEVIATION 164
Challenges of Anterocaudal Deviation 164
Management Strategies in Anterocadual Deviation 165
EXTRACORPOREAL RESECTION 165
ANTERIOR SEPTAL RECONSTRUCTION 165
Anterior Septal Reconstruction Technique 166
PATIENT OUTCOMES IN ANTERIOR SEPTAL RECONSTRUCTION 167
SUMMARY 168
ACKNOWLEDGMENTS 168
REFERENCES 168
The Inferior Turbinate in Rhinoplasty 171
Key points 171
INTRODUCTION 171
ANATOMY AND PHYSIOLOGY OF THE INFERIOR TURBINATE 172
CAUSES OF INFERIOR TURBINATE HYPERTROPHY 173
DIAGNOSIS OF INFERIOR TURBINATE HYPERTROPHY 173
TREATMENT FOR INFERIOR TURBINATE HYPERTROPHY 173
Nonsurgical Treatment 173
Surgical Treatment 174
Treating the bone: inferior turbinate lateralization 174
Treating the bone: submucosal resection of conchal bone 174
Inferior turbinate reduction with concurrent septoplasty 174
Inferior turbinectomy 175
Electrosurgery for inferior turbinate enlargement 175
PROPOSED ALGORITHM FOR TREATMENT OF INFERIOR TURBINATE HYPERTROPHY IN RHINOPLASTY 175
FUTURE DIRECTIONS 175
REFERENCES 175
The External Nasal Valve 179
Key points 179
ANATOMY 179
PHYSIOLOGY 183
ANALYSIS 183
MEASUREMENT 186
NONSURGICAL TREATMENT 186
SURGICAL TECHNIQUES 187
Caudal Septal Deformities 187
Tip Ptosis 188
Deprojection 188
Batten Grafts 188
Lateral Crus Modification 189
Alar Rim Grafts 191
Columellar Modification 191
Suspension Sutures 191
OUTCOMES 191
SUMMARY 193
REFERENCES 193
Functional Rhinoplasty 195
Key points 195
INTRODUCTION 195
ASSOCIATION BETWEEN NASAL ANATOMY AND FUNCTION 196
THE NASAL SEPTUM 196
THE INFERIOR TURBINATES 196
INTERNAL NASAL VALVE 197
EXTERNAL NASAL VALVE 198
SUMMARY 198
REFERENCES 199
Osteotomies Demystified 201
Key points 201
EVALUATION OF THE BONY NASAL VAULT 201
PERIOPERATIVE CONSIDERATIONS 202
Anesthesia 202
Adjunct Medications 202
OPERATIVE TECHNIQUES 203
Medial Osteotomy 203
Dorsal hump 203
Traditional medial osteotomy 204
Lateral Osteotomy 204
Endonasal approach 204
Percutaneous approach 205
Lateral osteotomy trajectories 206
Comparative data 206
Instrumentation 206
Transverse Osteotomy 206
Intermediate Osteotomy 207
Postoperative Care 208
SUMMARY 208
REFERENCES 208
Management of Pediatric Nasal Surgery (Rhinoplasty) 211
Key points 211
INTRODUCTION 211
HISTORICAL PERSPECTIVE 211
ANIMAL STUDIES 212
NASAL ANATOMY AND GROWTH 212
Embryology 212
Anatomy 212
Septum 212
Perpendicular plate and vomer 212
Lateral cartilages 212
Nasal bones 212
Growth 212
Abnormal Growth 213
Cartilage Regeneration 213
NASAL DEFORMITIES 213
PATIENT EVALUATION 213
NASAL SURGERY 214
TURBINATES 214
SEPTOPLASTY 214
RHINOPLASTY 215
NASAL TRAUMA 215
Pediatric Nasal Fracture Pattern: Nasal Bones 215
Pediatric Nasal Fracture Pattern: Septal Fractures 216
NASAL SEPTAL HEMATOMA/ABSCESS 217
CLEFT LIP NASAL DEFORMITY 217
NEONATAL NASAL AIRWAY OBSTRUCTION 218
LONG-TERM OUTCOMES 219
SUMMARY 219
REFERENCES 219
Cleft Septorhinoplasty 223
Key points 223
INTRODUCTION 223
EMBRYOLOGY 224
ANATOMIC DEFORMITY 224
Unilateral Cleft Lip Nasal Deformity and Dysfunction 224
Bilateral Cleft Lip Nasal Deformity 226
PRESURGICAL MANAGEMENT 227
Nasoalveolar Molding 227
Evidence-Based Approach to Presurgical Infant Orthopedics 228
PRIMARY CLEFT RHINOPLASTY 229
SECONDARY CLEFT SEPTORHINOPLASTY 230
Intermediate Rhinoplasty 230
Definitive Rhinoplasty 230
Surgical Approach 230
Alveolar Bone Grafting 231
Reconstruction of the Nasal Septum and Dorsum 231
Treatment of the Nasal Tip 234
Alar Rim 235
Alar Base 235
SUMMARY 235
REFERENCES 236
The Saddle Deformity 239
Key points 239
INTRODUCTION 239
ETIOLOGY AND DIAGNOSTIC CONSIDERATIONS 239
PHYSICAL EXAMINATION AND CLASSIFICATION 240
PATIENT COUNSELING 241
SURGICAL MANAGEMENT 241
Allograft Dorsal Correction 244
Homograft Dorsal Correction 244
Autologous Dorsal Correction 244
SURGICAL ADJUNCTS AND PEARLS 248
REVISION CASES 249
CONCLUDING THOUGHTS 249
REFERENCES 250
Revision Functional Surgery 251
Key points 251
INTRODUCTION 251
PREOPERATIVE ASSESSMENT 252
MIDDLE VAULT 253
NASAL TIP/LATERAL WALL 256
SUMMARY 261
REFERENCES 262
Advances in Technology for Functional Rhinoplasty 263
Key points 263
INTRODUCTION 263
FINITE ELEMENT MODELING 264
Nasal Septum and Dorsum 264
Cephalic Trim 264
Nasal Tip Support 264
COMPUTATIONAL FLUID DYNAMICS 265
Computational Fluid Dynamics Workflow 265
Computational Fluid Dynamics and Nasal Airway Obstruction 266
Computational Fluid Dynamics and Virtual Nasal Surgery 267
LIMITATIONS OF COMPUTATIONAL MODELING 267
SUMMARY 268
REFERENCES 269
Index 271