title: Management of the severe bulbous nasal tip using porous polyethylene alloimplants.
abstract: Reliable outcomes in correction of the severely bulbous nasal tip remain elusive. Reduction and binding of the tip cartilages result in a partial external nasal valve collapse. If a concurrent dorsal hump reduction is accomplished and osteotomies are completed to close the open roof deformity, then a severe constriction of the external valve may result. This is best avoided by resection of the residual lower lateral cartilages and substitution with external valve batten implants. The tripod of nasal tip supports is then rigidly reconstituted. When autogenous graft materials are considered inadequate or undesirable, the surgeon may safely use porous polyethylene alloimplants to support the external nasal valve. A dependable surgical technique based on extensive experience with these materials is outlined.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The New York Eye and Ear Infirmary, New York, NY, USA. docromo@aol.com
authors.forename: Thomas
authors.initials: T
authors.lastname: Romo
authors.forename: Jason A
authors.initials: JA
authors.lastname: Litner
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Sclafani
mesh_terms: D001672:Biocompatible Materials; D002356:Cartilage / Q000601:surgery / Q000637:transplantation; D005260:Female; D006801:Humans; D008297:Male; D009666:Nose / Q000601:surgery; D009668:Nose Diseases / Q000601:surgery*; D020959:Polyethylene; D011095:Polyethylenes; D019736:Prostheses and Implants; D012225:Rhinoplasty / Q000379:methods*
chemical_list: D001672:Biocompatible Materials; C084562:Medpor; D011095:Polyethylenes; D020959:Polyethylene