Rhinoplasty Flashcards
How to treat increased columellar show?
Resection caudal septum, medial crus, middle crus (or combination)
Detach lateral crura from accessory cartilage + pull inferior
Contour graft along alar rim
How to treat decreased columellar show?
Excision of vestibular skin
Columellar strut
How to increase nasal tip projection?
Suture: interdomal, transdomal, medial crural sutures
Graft: columellar strut, septal extension, extended spreader, tip graft
Decrease tip projection?
Transection of lateral crura LLC
Transection medial crura LLC
Transection both lateral + medial crura
Increase tip rotation?
Suture suspension of LLC to dorsal septum or osteocartilagenous junction
Cephalic trim LLC
Caudal septum resection (anterior)
Decrease tip rotation?
Release of LLC
Septal extension graft
Caudal septum resection (posterior)
How to treat boxy nasal tip?
Medial crural suture Interdomal suture Transdomal suture Lateral crural suture Tip rotation suture Lateral crural mattress suture Lateral crural strut graft
How to do dorsal hump reduction?
Separation of ULC from septum
Incremental reduction of septum
Incremental dorsal bony reduction with rasp
Verification by palpation
Final modification (spreader, suturing, osteotomies)
+/- ULC tension-spanning suture
Ways to augment the dorsum?
Dorsal onlay graft
Turkish delight
Synthetic implant: alloderm, silicone, gore-tex, medpor
How to correct alar flaring?
Wedge resection
How to correct alar rim deformity?
Alar contour graft
Lateral crural strut graft
What is saddle nose deformity?
Loss of dorsal height 2/2 substantial decrease in cartilagenous vault or bony vault
How to treat saddle nose deformity?
Re-establish support (rib cartilage - dorsal replacement graft +/- septal replacement strut)
Airway: external + internal valve collapse - spreader graft, batten graft
Nasal tip: columella strut with costal cartilage
Dorsum: temporal fascia w/ or w/o diced cartilage
Treatment of external nasal valve collapse?
Alar contour graft Extended alar contour graft Alar batten graft Lateral crural strut graft Correction of caudal septal deviation Correction of medial crural deformity
Treatment of internal nasal valve collapse?
Spreader graft
Autospreader graft
Turbinate work
Correct septal deviation
