title: Use of aesthetic rhinoplasty procedures in reconstructive nasal surgery.
abstract: Resection of cancer often involves the excision of underlying hard tissue, and some procedures in aesthetic rhinoplasty can be used in reconstructive nasal surgery to increase the margin of safety while still achieving an acceptable aesthetic and functional outcome. We have used techniques from aesthetic rhinoplasty to shape the nasal framework. Osteotomy and formation of the tip were used in 17 patients with defects (ranging from 1 to 3.5 cm in size) from the nasal root to the tip of the nose. After the underlying bony or cartilaginous framework, or both, had been removed, the resulting open roof deformity had to be corrected by osteotomy of the bony nasal wall and the tip shaped by excision and suturing, including insertion of the tip graft and columellar strut graft. After this, and narrowing of the nose, the defect was smaller and could be closed with local tissue without tension. There were no deformities in the contour, and patency of the airway was maintained. Patients were satisfied with both the aesthetic and functional results. Although the margin of safety was increased, shaping the nasal framework reduced the size of the defect, which allowed tension-free closure with a local flap. The operation requires a thorough knowledge of procedures used in aesthetic rhinoplasty.
authors.affiliation: Department of Oral, Maxillofacial of Surgery, University Hospital of RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany. Electronic address: aghassemi@ukaachen.de.
authors.forename: Alireza
authors.initials: A
authors.lastname: Ghassemi
authors.affiliation: Department of Dermatology, University Hospital of RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany.
authors.forename: Albert
authors.initials: A
authors.lastname: Rübben
authors.affiliation: Craniomaxillofacial Research Center, Azad University of Tehran, Tehran, Iran.
authors.forename: Behnam
authors.initials: B
authors.lastname: Bohluli
authors.affiliation: Department of Oral, Maxillofacial of Surgery, University Hospital of RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Hölzle
authors.affiliation: Department of Orthodontics, University Hospital of RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany.
authors.forename: Mehrangiz
authors.initials: M
authors.lastname: Ghassemi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009295:Nasal Bone / Q000601:surgery; D055171:Nasal Cartilages / Q000601:surgery; D009669:Nose Neoplasms / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps / Q000637:transplantation
keywords: Hump removal; Local flap; Osteotomy; Tip-forming; Tumour excision