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March 1982

Intraoral Insertion of Grafts to Project the Nasal Tip

Author Affiliations

From the Plastic Surgical Service, Melrose-Wakefield Hospital, Melrose, Mass, and Massachusetts Eye and Ear Infirmary, Boston (Dr Webster); Department of Otolaryngology, George Washington University, Washington, DC (Dr Hopping); Ear, Nose, and Throat Department, Veterans Administration Hospital, Seattle (Dr Patterson); and the Plastic, Aesthetic, and Cosmetic Surgery, Professional Corp, Brookline, Mass (Mr Smith, Ms Smith, and Dr Hall [a fellow at the time]). Dr Hall is now with the Walter Reed Army Medical Center, Washington, DC.

Arch Otolaryngol. 1982;108(3):187-193. doi:10.1001/archotol.1982.00790510059012

• Certain tip-projecting techniques require insertion of grafts and/or implants into the premaxillary region. These grafts may extend anteriorly into the columella or may have to reach all the way to the tip to exert the projecting forces exactly where the surgeon wishes to have them applied. The most direct technique for insertion of these long grafts is one of the columella-splitting maneuvers, but some patients will not accept the external scarline necessitated. An intraoral approach can be used in these patients or in any others in whom the surgeon wishes to have no external scar. It allows good exposure, easy insertion of the grafts and/or implants, and secure closure for stabilization and fixation of the grafts.

(Arch Otolaryngol 1982;108:187-193)