Triangular Resection of the Upper Lateral Cartilage for Middle Vault Deviation
Objectives Middle vault deviation has a significant effect on the aesthetic and functional aspects of the nose, and its management continues to be a challenge. Spreader graft and its modification techniques have been focused, but there has been scarce consideration for removing surplus portion and b...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Otorhinolaryngology-Head and Neck Surgery
2018-12-01
|
| Series: | Clinical and Experimental Otorhinolaryngology |
| Subjects: | |
| Online Access: | http://www.e-ceo.org/upload/pdf/ceo-2017-01816.pdf |
| _version_ | 1830162926895366144 |
|---|---|
| author | Gwanghui Ryu Min Young Seo Kyung Eun Lee Sang Duk Hong Seung-Kyu Chung Hun-Jong Dhong Hyo Yeol Kim |
| author_facet | Gwanghui Ryu Min Young Seo Kyung Eun Lee Sang Duk Hong Seung-Kyu Chung Hun-Jong Dhong Hyo Yeol Kim |
| author_sort | Gwanghui Ryu |
| collection | DOAJ |
| description | Objectives Middle vault deviation has a significant effect on the aesthetic and functional aspects of the nose, and its management continues to be a challenge. Spreader graft and its modification techniques have been focused, but there has been scarce consideration for removing surplus portion and balancing the upper lateral cartilage (ULC). This study aimed to report the newly invented triangular-shaped resection technique (“triangular resection”) of the ULC and to evaluate its efficacy for correcting middle vault deviation. Methods A retrospective study included 17 consecutive patients who presented with middle vault deviation and underwent septorhinoplasty by using triangular resection at a tertiary academic hospital from February 2014 and March 2016. Their outcomes were evaluated pre- and postoperatively including medical photographs, acoustic rhinometry and subjective nasal obstruction using a 7-point Likert scale. Results The immediate outcomes were evaluated around 1 month after surgery, and long-term outcomes were available in 12 patients; the mean follow-up period was 9.1 months. Nasal tip deviation angle was reduced from 5.66º to 2.37º immediately (P<0.001). Middle vault deviation also improved from 169.50º to 177.24º (P<0.001). Long-term results were 2.49º (P=0.015) for nasal tip deviation and 178.68º (P=0.002) for middle vault deviation. The aesthetic outcome involved a complete correction in eight patients (47.1%), a minimally visible deviation in seven patients (41.2%) and a remaining residual deviation in two patients (11.8%). Pre- and postoperative minimal cross-sectional areas (summation of the right and left sides) were 0.86 and 1.07, respectively (P=0.021). Fifteen patients answered about their nasal obstruction symptoms and the median symptom score had alleviated from 6.0 to 3.0 (P=0.004). Conclusion Triangular resection of the ULC is a simple and effective method for correcting middle vault deviation and balancing the ULCs without complications as internal nasal valve narrowing. |
| first_indexed | 2024-12-17T15:29:04Z |
| format | Article |
| id | doaj.art-da7d0ce50a0c4f43b37315a8e3ba3211 |
| institution | Directory Open Access Journal |
| issn | 1976-8710 2005-0720 |
| language | English |
| last_indexed | 2024-12-17T15:29:04Z |
| publishDate | 2018-12-01 |
| publisher | Korean Society of Otorhinolaryngology-Head and Neck Surgery |
| record_format | Article |
| series | Clinical and Experimental Otorhinolaryngology |
| spelling | doaj.art-da7d0ce50a0c4f43b37315a8e3ba32112022-12-21T21:43:12ZengKorean Society of Otorhinolaryngology-Head and Neck SurgeryClinical and Experimental Otorhinolaryngology1976-87102005-07202018-12-0111427528010.21053/ceo.2017.01816579Triangular Resection of the Upper Lateral Cartilage for Middle Vault DeviationGwanghui Ryu0Min Young Seo1Kyung Eun Lee2Sang Duk Hong3Seung-Kyu Chung4Hun-Jong Dhong5Hyo Yeol Kim Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaObjectives Middle vault deviation has a significant effect on the aesthetic and functional aspects of the nose, and its management continues to be a challenge. Spreader graft and its modification techniques have been focused, but there has been scarce consideration for removing surplus portion and balancing the upper lateral cartilage (ULC). This study aimed to report the newly invented triangular-shaped resection technique (“triangular resection”) of the ULC and to evaluate its efficacy for correcting middle vault deviation. Methods A retrospective study included 17 consecutive patients who presented with middle vault deviation and underwent septorhinoplasty by using triangular resection at a tertiary academic hospital from February 2014 and March 2016. Their outcomes were evaluated pre- and postoperatively including medical photographs, acoustic rhinometry and subjective nasal obstruction using a 7-point Likert scale. Results The immediate outcomes were evaluated around 1 month after surgery, and long-term outcomes were available in 12 patients; the mean follow-up period was 9.1 months. Nasal tip deviation angle was reduced from 5.66º to 2.37º immediately (P<0.001). Middle vault deviation also improved from 169.50º to 177.24º (P<0.001). Long-term results were 2.49º (P=0.015) for nasal tip deviation and 178.68º (P=0.002) for middle vault deviation. The aesthetic outcome involved a complete correction in eight patients (47.1%), a minimally visible deviation in seven patients (41.2%) and a remaining residual deviation in two patients (11.8%). Pre- and postoperative minimal cross-sectional areas (summation of the right and left sides) were 0.86 and 1.07, respectively (P=0.021). Fifteen patients answered about their nasal obstruction symptoms and the median symptom score had alleviated from 6.0 to 3.0 (P=0.004). Conclusion Triangular resection of the ULC is a simple and effective method for correcting middle vault deviation and balancing the ULCs without complications as internal nasal valve narrowing.http://www.e-ceo.org/upload/pdf/ceo-2017-01816.pdfRhinoplastyNoseAcquired Nasal DeformitiesNasal Cartilages |
| spellingShingle | Gwanghui Ryu Min Young Seo Kyung Eun Lee Sang Duk Hong Seung-Kyu Chung Hun-Jong Dhong Hyo Yeol Kim Triangular Resection of the Upper Lateral Cartilage for Middle Vault Deviation Clinical and Experimental Otorhinolaryngology Rhinoplasty Nose Acquired Nasal Deformities Nasal Cartilages |
| title | Triangular Resection of the Upper Lateral Cartilage for Middle Vault Deviation |
| title_full | Triangular Resection of the Upper Lateral Cartilage for Middle Vault Deviation |
| title_fullStr | Triangular Resection of the Upper Lateral Cartilage for Middle Vault Deviation |
| title_full_unstemmed | Triangular Resection of the Upper Lateral Cartilage for Middle Vault Deviation |
| title_short | Triangular Resection of the Upper Lateral Cartilage for Middle Vault Deviation |
| title_sort | triangular resection of the upper lateral cartilage for middle vault deviation |
| topic | Rhinoplasty Nose Acquired Nasal Deformities Nasal Cartilages |
| url | http://www.e-ceo.org/upload/pdf/ceo-2017-01816.pdf |
| work_keys_str_mv | AT gwanghuiryu triangularresectionoftheupperlateralcartilageformiddlevaultdeviation AT minyoungseo triangularresectionoftheupperlateralcartilageformiddlevaultdeviation AT kyungeunlee triangularresectionoftheupperlateralcartilageformiddlevaultdeviation AT sangdukhong triangularresectionoftheupperlateralcartilageformiddlevaultdeviation AT seungkyuchung triangularresectionoftheupperlateralcartilageformiddlevaultdeviation AT hunjongdhong triangularresectionoftheupperlateralcartilageformiddlevaultdeviation AT hyoyeolkim triangularresectionoftheupperlateralcartilageformiddlevaultdeviation |