title: [Combined nasal approach: maxilla-premaxilla approach and external approach].
abstract: BACKGROUND
  A major aim of septo-rhinoplasty is the treatment of the internal and external nasal defects overall. We describe our technique with a combined external approach and maxilla-premaxilla approach in one surgical process. We present our functional and aesthetic results.
  
  
  METHODS
  We analyse 16 patients that underwent septo-rhinoplasty using a combined approach; external approach and maxilla-premaxilla approach between 1999 and 2003. Anterior active rhinomanometry (RAA) and Anderson's scale to grade nose defects were performed before the operation and once again a year later. Furthermore, patients answered a visual analogical scale in order to know if they had noticed an improvement in nasal a year after the operation.
  
  
  RESULTS
  RAA showed significant improvement in nose flow by 100 Pa pressure with a total flow mean of 730 cm3/s after surgery. After the operation, the majority of patients felt a definitive improvement in their nasal respiration. Scores on Anderson's scale of nose defects showed a significant improvement in nasal defects after surgery p<0.001. We achieved also a significant improvement for each pyramidal subunit. There were no complications in the healing of incisions neither patients complained of them.
  
  
  CONCLUSIONS
  Nasal combined approach; external approach and maxilla-premaxilla approach in septo-rhinoplasty is a safe technique and allows functional and aesthetic improvement in nose defects, mainly in nasal base defects combined with septal defects.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Esperit Sant., Santa Coloma de Gramenet, Barcelona. nmir@hes.scs.es
authors.forename: N
authors.initials: N
authors.lastname: Mir Ulldemolins
authors.forename: X
authors.initials: X
authors.lastname: Barceló Colomer
authors.forename: S
authors.initials: S
authors.lastname: Díez Tejerina
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome