LATERAL CRURAL STRUT GRAFTS ASSOCIATED WITH CAUDAL ROTATION OF LOWER LATERAL CARTILAGES IN THE TREATMENT OF EXTERNAL NASAL VALVE DYSFUNCTION: CASE REPORT
Keywords:
Plastic surgery, Rhinoplasty, Nasal CartilagesAbstract
Introduction: Nasal valve concept includes internal and external valve (ENV). Conditions that alter the structure of the ENV precipitate its dysfunction. Objective: Report a case of ENV dysfunction treated with repositioning of lower lateral cartilages and use of lateral crural strut grafts (LCSG). Method: Case report with medical records and literature review. Results: Patient with nasal obstruction due to ENV dysfunction submitted to rhinoplasty using LCSG and caudal rotation of lateral crura. Discussion: Frequently used grafts in the treatment of valve dysfunction are alar contour grafts, alar batten grafts and LCSG. In situations with inadequate orientation of lower lateral cartilages, caudal rotation of lateral crura can be performed with repositioning inside a pocket in the alar rim. Conclusion: LCSG associated with caudal rotation of lower lateral cartilages allow greater support of alar margin and effectively treat NEV, restoring its function.
References
Steffen N, Martins ALM, Steffen LP. Livro do DESC. 1st ed. Saldanha O, Prado Neto J de M, Chaves LO, Steffen N, editors. Vol. 3. Rio de Janeiro: Dilivros; 2018. p. 87–100.
Troell RJ, Powell NB, Riley RW, Li KK. Evaluation of a new procedure for nasal alar rim and valve collapse: Nasal alar rim reconstruction. Otolaryngology - Head and Neck Surgery. 2000;122(2):204–11.
Dolci ELL, Dolci JEL. Algorithm for the treatment of external nasal valve insufficiency. Brazilian Journal of Otorhinolaryngology. 2020 Sep 1;86(5):579–86.
Ferreira JCR, Piteri RCO. A Cirurgia Plástica em Capítulos. 1st ed. Boggio R, Calazans D, editors. Vol. 1. São Paulo: Universo DOC; 2021. p. 501–539.
Kalan A, Kenyon GS, Seemungal TAR. Treatment of external nasal valve (alar rim) collapse with an alar strut. Journal of Laryngology and Otology. 2001;115(10):788–91.
Unger JG, Roostaeian J, Small KH, Pezeshk RA, Lee MR, Harris R, et al. Alar contour grafts in rhinoplasty: A safe and reproducible way to refine alar contour aesthetics. Plastic and Reconstructive Surgery. 2016 Jan;137(1):52–61
Cochran CS, Sieber DA. Extended alar contour grafts: An evolution of the lateral crural strut graft technique in rhinoplasty. Plastic and Reconstructive Surgery. 2017;140(4):559E-567E.
Kondo M, Orgain C, Alvarado R, Marcells GN, Harvey RJ. The effects of lateral crural tensioning with an articulated alar rim graft versus lateral crural strut graft on nasal function. Facial Plastic Surgery and Aesthetic Medicine. 2020 Jul 1;22(4):281–5.
Gunter JP, Landecker A, Cochran CS. Frequently used grafts in rhinoplasty: nomenclature and analysis. Plastic and Reconstructive Surgery. 2006 Jul;118(1).
Rohrich RJ, Durand PD. Expanded Role of Alar Contour Grafts. Plastic and Reconstructive Surgery. 2021;780–5.
Ballin AC, Kim H, Chance E, Davis RE. The Articulated Alar Rim Graft: Reengineering the Conventional Alar Rim Graft for Improved Contour and Support. Facial Plastic Surgery. 2016 Aug 1;32(4):384–97.
Gunter JP, Friedman RM. Lateral crural strut graft: Technique and clinical applications in rhinoplasty. Plastic and Reconstructive Surgery. 1997 Apr;99(4):943–55.
Sheen J, Sheen A. Aesthetic Rhinoplasty. 2nd ed. St Louis: Mosby; 1987.
Mohebbi A, Azizi A, Tabatabaiee S. Repositioned lateral crural flap technique for cephalic malposition in rhinoplasty. Plastic Surgery. 2015;23(3):183.
Ilhan AE, Saribas B, Caypinar B. Aesthetic and Functional Results of Lateral Crural Repositioning. JAMA Facial Plastic Surgery. 2015 Jul;17(4):286–92.
Toriumi DM, Asher SA. Lateral Crural Repositioning for Treatment of Cephalic Malposition. Facial Plastic Surgery Clinics of North America. 2015 Feb;23(1):55–71.
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