gms | German Medical Science

Introduction: Alar cartilages are primary nasal tip supporting structure. The aim of alar cartilage surgery is nasal tip alterations in size, rotation and projection. Indications for approaches to the alar cartilage depend on the specific anatomy of the nose and the proposed changes. The aim of this work is to present our experience with alar cartilage surgery.

Methods: It is retrospective descriptive study when we used rhinoplasty cases (61) for 3 year (2006–08). From these, 41% cases (25) were with nasal tip abnormalities. 11 cases were from nasal tip bulosis. In our cases we were applied non-delivery (93% cases) and external (7% cases) approaches.

Results: We were applied transcartilaginous incisions (34%) and intercartilaginous & marginal incisions (7%) from all rhinoplasty cases when needed alar cartilage surgery.

Alar cartilage surgical procedures in our cases were; lateral crura surgery (complete strip technique 34%, weakening procedure 5%, dome division 2%, inter-domal sutures 31%, trans-domal sutures 7%.

Conclusions: Surgeons experience is most important role in alar cartilage surgery. Nowadays most rhinosurgeons in the word usually performed open approach for cartilage surgery. This approach we were applied in 7% of cases. In majority of cases is possible alar cartilage surgery with intranasal approaches. We recommend surgical approaches to the nasal tip advocated by Tardy.

Keywords: alar cartilage, nasal tip, rhinoplasty, incisions, surgical approaches.