Hossam M T Foda1. 1. Department of Otolaryngology-Head & Neck Surgery, Alexandria Medical School, Alexandria, Egypt. hfoda@dataxprs.com.eg
Abstract
PURPOSE: To evaluate the problems encountered on revising a multiply operated nose and the methods used in correcting such problems. PATIENTS AND METHODS: The study included 50 cases presenting for revision rhinoplasty after having had 2 or more previous rhinoplasties. An external rhinoplasty approach was used in all cases. Simultaneous septal surgery was done whenever indicated. All cases were followed for a mean period of 32 months (range, 1.5-8 years). Evaluation of the surgical result depended on clinical examination, comparison of pre- and postoperative photographs, and degree of patients' satisfaction with their aesthetic and functional outcome. RESULTS: Functionally, 68% suffered nasal obstruction that was mainly caused by septal deviations and nasal valve problems. Aesthetically, the most common deformities of the upper two thirds of the nose included pollybeak (64%), dorsal irregularities (54%), dorsal saddle (44%), and open roof deformity (42%), whereas the deformities of lower third included depressed tip (68%), tip contour irregularities (60%), and overrotated tip (42%). Nasal grafting was necessary in all cases; usually more than 1 type of graft was used in each case. Postoperatively, 79% of the patients, with preoperative nasal obstruction, reported improved breathing; 84% were satisfied with their aesthetic result; and only 8 cases (16%) requested further revision to correct minor deformities. CONCLUSION: Revision of a multiply operated nose is a complex and technically demanding task, yet, in a good percentage of cases, aesthetic as well as functional improvement are still possible.
PURPOSE: To evaluate the problems encountered on revising a multiply operated nose and the methods used in correcting such problems. PATIENTS AND METHODS: The study included 50 cases presenting for revision rhinoplasty after having had 2 or more previous rhinoplasties. An external rhinoplasty approach was used in all cases. Simultaneous septal surgery was done whenever indicated. All cases were followed for a mean period of 32 months (range, 1.5-8 years). Evaluation of the surgical result depended on clinical examination, comparison of pre- and postoperative photographs, and degree of patients' satisfaction with their aesthetic and functional outcome. RESULTS: Functionally, 68% suffered nasal obstruction that was mainly caused by septal deviations and nasal valve problems. Aesthetically, the most common deformities of the upper two thirds of the nose included pollybeak (64%), dorsal irregularities (54%), dorsal saddle (44%), and open roof deformity (42%), whereas the deformities of lower third included depressed tip (68%), tip contour irregularities (60%), and overrotated tip (42%). Nasal grafting was necessary in all cases; usually more than 1 type of graft was used in each case. Postoperatively, 79% of the patients, with preoperative nasal obstruction, reported improved breathing; 84% were satisfied with their aesthetic result; and only 8 cases (16%) requested further revision to correct minor deformities. CONCLUSION: Revision of a multiply operated nose is a complex and technically demanding task, yet, in a good percentage of cases, aesthetic as well as functional improvement are still possible.
Authors: Paulo Fernando Tormin Borges Crosara; Flávio Barbosa Nunes; Danilo Santana Rodrigues; Ana Rosa Pimentel Figueiredo; Helena Maria Gonçalves Becker; Celso Goncalves Becker; Roberto Eustáquio Santos Guimarães Journal: Int Arch Otorhinolaryngol Date: 2016-09-22