title: [The nasal framework in rhinoplasty and its dimensions: the importance of a third element].
abstract: BACKGROUND
  Reconstructing a crooked nose has been a challenge. Reshaping a nose reducing or improving its profile may be followed by irregularities and functional troubles. The principles of the extracorporeal septoplasty were launched in the 50's, consisting of the treatment of the septal framework outside the nose. Thus, it is replaced and fixed inside the nose. Dorsal irregularity or low projection may be overcome with a dorsal onlay graft.
  
  
  OBJECTIVE
  To describe an evolution of extracorporeal rhinoseptoplasty based on a three-dimensional reshaping of the nasal framework, and its average dimensions.
  
  
  METHODS
  Data of patients presenting nasal obstruction related to septal deviation and operated by the proposed technique were collected prospectively. The dimensions of the framework were measured during the surgery.
  
  
  RESULTS
  25 patients were operated from February to September 2010. Fifteen (60%) cases were related to previous trauma or surgery. The other 40% (N=10) were primary, claiming mainly a reduction rhinoplasty. A closed approach was used for all but one (4%). In 12% (N=3) of the patients no lateral osteotomies were performed after opening the bony roof. Tip surgery was performed in 32% (N=8).
  
  
  CONCLUSIONS
  The principles of the "three-dimensional framework technique" are globally reproducible independently of the amount of residual septal cartilage. We believe that our technique assures more stability to the framework and offers a better regularity of the nasal dorsum, eliminating the need of an open approach if other manoeuvres requiring it are not associated.
authors.affiliation: Hôpital Edouard Herriot, Otolaryngologist, Fellowship (AFSA), Service of Otorhinolaryngology, Head and Neck Surgery, 5 Place d'Arsonval, Pavillon U, 69437 Lyon cedex 03, France. dr.cesarleandro@gmail.com
authors.forename: C L
authors.initials: CL
authors.lastname: Terra Brito
authors.forename: F
authors.initials: F
authors.lastname: Disant
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000209:etiology / Q000601:surgery; D009300:Nasal Septum / Q000002:abnormalities / Q000293:injuries / Q000601:surgery*; D011446:Prospective Studies; D012225:Rhinoplasty / Q000379:methods*; D055815:Young Adult