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Congenital Nasal Disorders
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
The commonest congenital nasal mass is a dermoid cyst. This is typically a smooth midline swelling on the dorsum of the nose under the skin. There may be an external ‘punctum’. It is thought to result from inclusion of epithelial cells along lines of fusion, hence the tendency for it to occur in the midline. The cyst contains thick, often viscous fluid, with ectodermal and mesodermal components, sometimes including skin appendages and hair follicles. It may become infected, but more often the parents will present with aesthetic concerns. Careful evaluation including detailed imaging is essential, not least to exclude an intracranial connection as these lesions can invaginate deeply into the midline nasal cartilages and beyond, making excision very challenging.
ENT Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Look carefully for a septal haematoma which, if left, leads to necrosis of the nasal cartilage and septal collapse. The nasal passage is blocked by a dull-red swelling replacing the septum, associated with marked nasal obstruction.
Aesthetic Regions of the Face
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Alessandro Gualdi, Michele Pascali, Heidi A. Waldorf, Rene van der Hulst, Philippe Magistretti, Dario Bertossi
The deep subcutaneous branch divides close to the alar nasal sulcus to form the lateral nasal and angular arteries. In Africans, short noses with large nostrils and tips are characteristic. The central maxilla is well developed and protrudes anteriorly. The nasal dorsum is usually flat and the radix is located slightly above the intercanthal line. Asian patients have a flat nose, low radix and underrepresented dorsum. The nostrils are thin, and the tip is usually very short and rounded. With aging, the nasal cartilage enlarges and the nasal bone cavity widens. The cartilage becomes thinner and the tip falls downward. Although the bony dorsum does not change in older patients, it may become thinner, with a “sharper” edge. The lateral nasal vessels run above the alar groove to provide vascularization to the tip of the nose, together with an artery coming from the superior labial artery and passing through the columella. The tip is highly vascularized, especially in the superficial plane.
Reconstructive rhinoplasty using cadaver cartilage in relapsing polychondritis
Published in Baylor University Medical Center Proceedings, 2023
Rishabh Shah, Eugene L. Alford
A 55-year-old woman with known relapsing polychondritis and a 40-pack-year smoking history presented with loss of nasal function. She had lost almost all the cartilage in her nose over 10 years earlier, resulting in a saddle nose deformity. She had near total nasal obstruction and presented to the clinic seeking surgical reconstruction. She also had overrotation of the nasal tip (middle valve collapse). Internally, there was no nasal septum, and the nasal vestibule was 4 mm on each side. Two MTF Biologics frozen rib grafts were selected for reconstruction, one for the dorsal onlay and another for the strut graft. One month after nasal reconstruction with cadaver rib graft, the patient was very pleased with the esthetic and functional results (Figure 1). Breathing was patent in nostrils bilaterally. At 1-year follow-up, her autoimmune condition had worsened. She gained about 40 pounds while on steroids; however, her nasal reconstruction from a cosmetic and functional standpoint was much improved. On exam, the nasal cartilage graft was stable and well integrated. The nasal passageways were widely patent and there was no evidence of a saddle nose deformity.
A new technique for Asian nasal tip shaping: "twin tower" folding ear cartilage transplantation
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Long Zhang, Jiang-wen Wang, Jun Ding, Xi Zhang, Xi-mei Wang, Zhan-zhao Zhang, Run-ze Yu
Rhinoplasty is a common, yet relatively complex, operation in cosmetic surgery, and the focus is on the establishment of structural support for the nasal cartilage and shaping of the nasal tip [4]. In recent years, many Western Dallas rhinoplasty techniques and concepts have been promoted in China, but for Orientals, most of their noses are not three-dimensional enough. Therefore, it is necessary to carry out rhinoplasty surgery according to the characteristics of Orientals. Most of the surgical plans we take are mainly to raise the bridge of the nose and the tip of the nose [5]. Autologous cartilage is the material of choice in nose tip shaping, including ear cartilage, septal cartilage, and costal cartilage, but each has its own advantages and disadvantages. In clinical practice, we found that compared with the nasal septal cartilage or costal cartilage, the application of ear cartilage in nose tip shaping can also achieve the same effect of elevating the nose tip and lengthening the length of the nose tip [5].
Posterior lamellar reconstruction: a comprehensive review of the literature
Published in Orbit, 2019
Alessandra Fin, Fabrizio De Biasio, Paolo Lanzetta, Sebastiano Mura, Anna Tarantini, Pier Camillo Parodi
Grafts of nasal cartilage and the overlying mucosa can be used to reconstruct both layers of the posterior lamella. Although histologically different, these grafts provide a structure very similar to the original tissue. Furthermore, nasal mucosa harvested from the turbinates or septum can be used to replace missing conjunctival tissue. Indeed, nasal mucosa is thicker than buccal mucosa and presents a lower incidence of scar contraction. Despite this advantage, and modified versions designed to simplify the technique,67 chondromucosal grafts harvested from the septum, or, less frequently from other nasal components, have only rarely been described in the literature, and only in cases of total or subtotal reconstruction of the eyelids.68–70 Indeed, the less practical harvesting, morbidity at the donor site, and risk of bleeding render this a relatively unpopular technique among oculoplastic surgeons.