Artikel
Alar batten graft modification in revision surgery of nasal valve stenosis
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Veröffentlicht: | 22. Juli 2009 |
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Gliederung
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Introduction: Surgery of the nasal valve is challenging, especially in revision rhinoplasties. The reconstructed nasal valve has to counteract substantial contractile forces to provide a sufficient nasal airway.
Method: We demonstrate a modification of the established alar batten graft in 6 cases of open revision rhinoplasties. The patients had undergone one to three previous surgeries, including alar wedge excision. Due to substantial contraction, established techniques such as the alar batten graft, were not sufficient to treat these patients. We describe the placement of two costal cartilage grafts spanning from the pirifom aperture to the anterior septal angle. This resulted in a semicircular arc that withstands the collapsing forces of scar contracture well.
Results: In combination with further techniques the collapse of the nasal valve could be prevented. All patients reported an improvement of their nasal breathing with follow-up of 3 months to 3 years. An improvement of sleep quality was noticed in 4 of 6 cases. The favorable cosmetic results of this graft are depicted on representative postoperative photographs.
Conclusion: The described extended alar batten grafts represent an alternative technique for the correction of severe nasal valve collapse. Costal cartilage provides for enough length and strength to fashion the semicircular arc described herein.