PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 10196437

Functional nasal surgery.

R J Schlosser·S S Park
View original source ↗Export metadata ↓

Abstract

Functional nasal surgery is designed to repair nasal obstruction frequently caused by previous reduction rhinoplasty or blunt nasal trauma. Distinguishing the statically narrowed nasal valve from the weak sidewall with dynamic collapse is an important part of the preoperative evaluation. Our workhorse for repair of static obstruction is the combination of spreader grafts and flaring sutures, which together create a significant increase in the intranasal valve area. Dynamic collapse of the sidewall is corrected with cartilaginous batten grafts designed to increase sidewall rigidity. Less common causes of valve obstruction, such as tip ptosis, facial paralysis, cicatricial stenosis, Mohs reconstruction, and paradoxical lateral crura, are repaired by more individualized techniques.

Explore related subjects

CartilageHumansNasal ObstructionNasal SeptumRhinoplastyTurbinatesJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

R J Schlosser, S S Park. 1999. Functional nasal surgery.. https://doi.org/10.1016/s0030-6665(05)70114-6

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2000

A mutation in the alpha 3 chain of type IX collagen causes autosomal dominant multiple epiphyseal dysplasia with mild myopathy.

Multiple epiphyseal dysplasia (MED) is a degenerative cartilage condition shown in some cases to be caused by mutations in genes encoding cartilage oligomeric matrix protein or type IX collagen. We studied a family with autosomal dominant MED affecting predominantly the knee joints and a mild proximal myopathy. Genetic linkage to the COL9A3 locus on chromosome 20q13.3 was established with a peak log(10) odds ratio for linkage score of 3.87 for markers D20S93 and D20S164. Reverse transcription-PCR performed on the muscle biopsy revealed aberrant mRNA lacking exon 3, which predicted a protein lacking 12 amino acids from the COL3 domain of alpha3(IX) collagen. Direct sequencing of genomic DNA confirmed the presence of a splice acceptor mutation in intron 2 of the COL9A3 gene (intervening sequence 2, G-A, -1) only in affected family members. By electron microscopy, chondrocytes from epiphyseal cartilage exhibited dilated rough endoplasmic reticulum containing linear lamellae of alternating electron-dense and electron-lucent material, reflecting abnormal processing of mutant protein. Type IX collagen chains appeared normal in size and quantity but showed defective cross-linking by Western blotting. The novel phenotype of MED and mild myopathy is likely caused by a dominant-negative effect of the exon 3-skipping mutation in the COL9A3 gene. Patients with MED and a waddling gait but minimal radiographic hip involvement should be evaluated for a primary myopathy and a mutation in type IX collagen.

Cartilage↗
PubMed2000

Correction of severe caudal deflections with a cartilage "plating" rigid fixation graft.

OBJECTIVE: To evaluate a technique for correction of severe caudal septal defects. DESIGN: For all patients, preoperative photographs were analyzed and subjective nasal airway patency surveys were conducted. The caudal septal defects were then repaired with the cartilage "plating" rigid fixation technique. The intraoperative findings were documented in pictorial diagrams. Postoperative photographs and repeated airway surveys were obtained during the subsequent follow-up visits. Preoperative data and long-term postoperative data were compared and analyzed. SETTING: Private practice, ambulatory surgical center. PATIENTS: Thirty-six patients had significant caudal septal deviations and functional airway obstruction. MAIN OUTCOME MEASURES: Accuracy and stability of the correction, airway improvement, patient satisfaction, and morbidity. RESULTS: Since 1988, 36 patients were treated for severe caudal septal defects using cartilage plating rigid fixation. Follow-up visits have ranged from 3 to more than 9 years. All patients have maintained an accurate correction of their caudal septal deflections. All patients have also noted subjective improvement of their nasal airway. No complication has been encountered. CONCLUSION: Cartilage plating rigid fixation seems to be an effective method of correcting the functional problems associated with severe caudal septal deformities.

Cartilage↗