The Use of Bony Septum as an Extended Spreader Graft in Primary and Secondary Rhinoplasty
Objective: To describe a surgical technique using bony septum, specifically vomer or perpendicular plate of the ethmoid (PPE), as an extended spreader graft (ESG) for securing septal extension graft (SEG) and for correcting internal nasal valve dysfunction. Methods: Design: Descri...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Philippine Society of Otolaryngology-Head and Neck Surgery, Inc.
2019-06-01
|
| Series: | Philippine Journal of Otolaryngology Head and Neck Surgery |
| Subjects: | |
| Online Access: | https://pjohns.pso-hns.org/index.php/pjohns/article/view/961 |
| _version_ | 1817990611448365056 |
|---|---|
| author | Candice Que - Ansorge Eduardo C. Yap |
| author_facet | Candice Que - Ansorge Eduardo C. Yap |
| author_sort | Candice Que - Ansorge |
| collection | DOAJ |
| description | Objective: To describe a surgical technique using bony septum, specifically vomer or perpendicular plate of the ethmoid (PPE), as an extended spreader graft (ESG) for securing septal extension graft (SEG) and for correcting internal nasal valve dysfunction.
Methods:
Design: Descriptive Case Series
Setting: Tertiary Private Hospital
Participants: Thirty-two (32) patients who underwent aesthetic rhinoplasty from May 2016 to October 2017 were evaluated, and ten (10) patients presenting with symptomatic obstruction were considered for inclusion. The surgical technique was applied in patients with weak SEG for control of nasal length and tip projection who had inadequate septal cartilage for SEG and ESG intraoperatively. Results were evaluated grossly under direct vision intra-operatively and post-operatively to check the patency of the internal valve.
Results: Bony septum was used as an ESG in five (5) patients (1 male, 4 females, ages 35 to 50-years-old) with inadequate septal cartilage. Intraoperative evaluation under direct vision showed anterior caudal septal deviation in all 5 patients in whom correction was confirmed after placement of SEG and ESG. Immediate post-operative evaluation confirmed bilaterally patent nasal valve in all 5, who reported subjectively improved breathing at 2 and 4 weeks post-operatively. Post-operative photographs showed improvement of nasal length and tip.
Conclusion: The use of the bony septum (vomer and PPE) as an ESG for primary or secondary rhinoplasty is a potentially effective means of supporting and securing the SEG for control of nasal length, preventing tip deviation or rotation and for improving internal valve function. Further trials are needed to establish its reliability and long-term effectivity.
Keywords: rhinoplasty; vomer; perpendicular plate of the ethmoid (PPE) |
| first_indexed | 2024-04-14T01:01:32Z |
| format | Article |
| id | doaj.art-8a110bfdad4f42b5b15953b3f1a9610b |
| institution | Directory Open Access Journal |
| issn | 1908-4889 2094-1501 |
| language | English |
| last_indexed | 2024-04-14T01:01:32Z |
| publishDate | 2019-06-01 |
| publisher | Philippine Society of Otolaryngology-Head and Neck Surgery, Inc. |
| record_format | Article |
| series | Philippine Journal of Otolaryngology Head and Neck Surgery |
| spelling | doaj.art-8a110bfdad4f42b5b15953b3f1a9610b2022-12-22T02:21:24ZengPhilippine Society of Otolaryngology-Head and Neck Surgery, Inc.Philippine Journal of Otolaryngology Head and Neck Surgery1908-48892094-15012019-06-0134110.32412/pjohns.v34i1.961The Use of Bony Septum as an Extended Spreader Graft in Primary and Secondary RhinoplastyCandice Que - Ansorge0Eduardo C. Yap1Metropolitan Medical Center Department of Otorhinolaryngology – Head and Neck SurgeryMetropolitan Medical Center Department of Otorhinolaryngology – Head and Neck SurgeryObjective: To describe a surgical technique using bony septum, specifically vomer or perpendicular plate of the ethmoid (PPE), as an extended spreader graft (ESG) for securing septal extension graft (SEG) and for correcting internal nasal valve dysfunction. Methods: Design: Descriptive Case Series Setting: Tertiary Private Hospital Participants: Thirty-two (32) patients who underwent aesthetic rhinoplasty from May 2016 to October 2017 were evaluated, and ten (10) patients presenting with symptomatic obstruction were considered for inclusion. The surgical technique was applied in patients with weak SEG for control of nasal length and tip projection who had inadequate septal cartilage for SEG and ESG intraoperatively. Results were evaluated grossly under direct vision intra-operatively and post-operatively to check the patency of the internal valve. Results: Bony septum was used as an ESG in five (5) patients (1 male, 4 females, ages 35 to 50-years-old) with inadequate septal cartilage. Intraoperative evaluation under direct vision showed anterior caudal septal deviation in all 5 patients in whom correction was confirmed after placement of SEG and ESG. Immediate post-operative evaluation confirmed bilaterally patent nasal valve in all 5, who reported subjectively improved breathing at 2 and 4 weeks post-operatively. Post-operative photographs showed improvement of nasal length and tip. Conclusion: The use of the bony septum (vomer and PPE) as an ESG for primary or secondary rhinoplasty is a potentially effective means of supporting and securing the SEG for control of nasal length, preventing tip deviation or rotation and for improving internal valve function. Further trials are needed to establish its reliability and long-term effectivity. Keywords: rhinoplasty; vomer; perpendicular plate of the ethmoid (PPE)https://pjohns.pso-hns.org/index.php/pjohns/article/view/961rhinoplastyvomerperpendicular plate of the ethmoid (PPE) |
| spellingShingle | Candice Que - Ansorge Eduardo C. Yap The Use of Bony Septum as an Extended Spreader Graft in Primary and Secondary Rhinoplasty Philippine Journal of Otolaryngology Head and Neck Surgery rhinoplasty vomer perpendicular plate of the ethmoid (PPE) |
| title | The Use of Bony Septum as an Extended Spreader Graft in Primary and Secondary Rhinoplasty |
| title_full | The Use of Bony Septum as an Extended Spreader Graft in Primary and Secondary Rhinoplasty |
| title_fullStr | The Use of Bony Septum as an Extended Spreader Graft in Primary and Secondary Rhinoplasty |
| title_full_unstemmed | The Use of Bony Septum as an Extended Spreader Graft in Primary and Secondary Rhinoplasty |
| title_short | The Use of Bony Septum as an Extended Spreader Graft in Primary and Secondary Rhinoplasty |
| title_sort | use of bony septum as an extended spreader graft in primary and secondary rhinoplasty |
| topic | rhinoplasty vomer perpendicular plate of the ethmoid (PPE) |
| url | https://pjohns.pso-hns.org/index.php/pjohns/article/view/961 |
| work_keys_str_mv | AT candicequeansorge theuseofbonyseptumasanextendedspreadergraftinprimaryandsecondaryrhinoplasty AT eduardocyap theuseofbonyseptumasanextendedspreadergraftinprimaryandsecondaryrhinoplasty AT candicequeansorge useofbonyseptumasanextendedspreadergraftinprimaryandsecondaryrhinoplasty AT eduardocyap useofbonyseptumasanextendedspreadergraftinprimaryandsecondaryrhinoplasty |