Severe iatrogenic nostril stenosis.

Sir,

We have read with great interest, the article[1] of Ebrahimi and Shams concerning a case with severe post-operative nostril stenosis in a female patient who underwent multiple – primary and secondary – rhinoplasty operations.

The risk of nostril stenosis development after primary rhinoplasty is not high but the cost following it can be, especially important. The appearance of a severe complication following a purely aesthetic surgical intervention can turn a healthy person to a patient with unexpected consequences. We believe that, in such cases where nostril constriction is possible to happen due to nasal valve intra-operative injury, prevention might be the best solution following the basic “better safe than sorry” principle.

Many different internal nasal splints[234] have been proposed over time. In similar cases where the nasal valve was affected, we have used a simple, “handmade” internal nasal splint made of X-ray film pieces [Figures 1 and 2]. We have recently used them not only on post-nasal valve injury patients with high risk of nostril stenosis development but also as a standard post-rhinoplasty splint. Their use is based on the creation of a cylinder splint, taking advantage of elastic properties of an X-ray film. After forming the splint and placing into the nostrils, it tends to unfold maintaining intra-nasal space and keeping the airway open and easily accessible [Figure 2].

Figure 1

X-ray film piece formed as cylinder splint

Figure 2

Splints placed into the nostrils post-operatively

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