Peter J. F. M. Lohuis, MD, PhD, and colleagues describe their results using the split hump technique (SHT) in aesthetic rhinoplasty while emphasizing the additional advantage of this approach. The SHT allows for a more controlled reduction of the nasal dorsum with preservation of the entire upper lateral cartilage (ULC) during deprojection. This, in turn, enables more precise resection of the ULCs and less destabilizing of the key area. Ninety-seven patients who underwent rhinoplasty for aesthetic reasons using the SHT were evaluated for aesthetic contentment and functional satisfaction recorded by a questionnaire. Results demonstrate a significant subjective increase in both aesthetic and functional outcomes. The authors strongly recommend the use of the SHT to rhinoplasty surgeons.
Doo Hee Han, MD, PhD, and colleagues present a retrospective review regarding functional and aesthetic outcomes of methods used for nasal alar reconstruction in Asian patients while stating the criteria for selection of these methods. Although outcomes and criteria have been studied in Western populations, this is the first study in Asian people. The study consists of 17 patients, of whom 2 are described as representative cases. Objective and subjective aesthetic outcomes are evaluated along with subjective functional findings. Results show that the size and depth of the defect primarily affects the choice of reconstruction in Asian patients. The authors propose a working algorithm for reconstruction of nasal alar defects with respect to these 2 components.
Derek J. Lam, MD, MPH, and colleagues question the relationship between cleft width and other risk factors with occurrence of velopharyngeal insufficiency (VPI). A total of 61 patients with isolated cleft palates (Veau type 2) are retrospectively surveyed for the presence of VPI, and the correlation with various parameters, including width and length of cleft, type of surgery, and age at which the operation was performed, are analyzed. Results show a significantly higher overall rate of VPI in subjects with a cleft width greater than 10 mm. The authors conclude that cleft width should be considered as a prognostic indicator of postoperative VPI, regardless of the Veau type.
John S. Rhee, MD, MPH, and colleagues demonstrate the use of computational fluid dynamics (CFD)-aided virtual surgery planning in evaluating the effects of individual components of functional nasal airway surgery. They accomplish this by evaluating nasal airway resistance and airflow allocation in preoperative and postoperative 3-dimensional digital nasal models created from computed tomographic images. Results prove that septoplasty and inferior turbinate reduction have the highest impact on reduction of nasal resistance, but the authors also state that contribution from nasal valve repair surgery is significant. They conclude with the proposition that CFD-aided surgery may be used for preoperative planning for a more successful outcome in patients with multifactorial anatomic nasal airway obstruction.
Portrait of a Man Holding a Book, by Titian (Tiziano Vecellio) (about 1488 to 1576).
This issue's Highlights were written by Ismet Emrah Emre, MD.
Highlights of Archives of Facial Plastic Surgery. Arch Facial Plast Surg. 2012;14(5):311. doi:10.1001/archfacial.2012.1014