Comparison of Various Rhinoplasty Techniques and Long-Term Results

The Merits of the External Rhinoplasty

The authors present their views on the merits of external rhinoplasty in the context of a renewed awareness of the endonasal approach. Why do we continue to perform rhinoplasty via an open approach? The benefits of this technique such as its unparalleled exposure, the opportunity for technical precision, and the ability to better preserve nasal function are thoroughly explored. The criticisms of this technique are presented and discussed. The authors thoughts on rhinoplasty as a whole are examined.

Postoperative malodorous smell in open septorhinoplasty: the effect of intradomal suturing with mucosal release

PURPOSE

The aim of this study was to test a mucosal release method for decreasing the occurrence of malodourous smells after septorhinoplasty by preventing formation of debris pockets after surgery.

METHODS

This study included 50 adult patients from 18 to 45 years of age who underwent open septorhinoplasty from January to May 2019. Patients were divided into two groups. The first group had intradomal (transdomal) sutures without submucosal release, while the second group had mucosal release. All patients had scheduled post-op visits at 1, 2, 4, and 8 weeks and 6 months.

RESULTS

The overall postoperative rate of malodorous smell in both mucosal release and non-mucosal release patients at 2 weeks, 8 weeks and 6 months was 43.1%, 31.4% and 5.9%, respectively. Patients 36-45 years of age had a higher rate of postoperative malodorous smell with 55.6% at 2 weeks, decreasing to 33.3% at 8 weeks, and to less than 1% at 6 months. At 2 weeks after surgery, only 20% of the mucosal release group reported a malodorous smell compared to 65.4% in the non-mucosal release group. The rate was 8% at 8 weeks, and less than 1% at 6 months in the mucosal release group compared to 53.8% at 8 weeks and 11.5% at 6 months in the non-mucosal release group.

CONCLUSIONS

Utilizing absorbable polydioxanone sutures and releasing the vestibular mucosa of the LLC significantly reduced the rate of postoperative malodorous smell for septorhinoplasty patients with intradomal (transdomal) single-dome suturing.

Noses of the Middle East: Variety of Phenotypes and Surgical Approaches

BACKGROUND

The Middle East (ME) proper, a vast area between the East coast of the Mediterranean Sea and Afghanistan, is populated by many nations and tribes. Several nose phenotypes are prevalent throughout the region, but there is no published study encompassing and exploring nose phenotypes encountered in the various countries and subregions of the ME.

METHODS

The current study was based on the analysis of compiled data from 1207 patients of ME origin (53% of my total rhinoplasty patient cohort) operated by the author during the years 1985 to 2015. Among them 1046 (86.5%) underwent primary rhinoplasty and 161 (13.5%) were previously operated elsewhere, almost all in the ME.

RESULTS

The following nose subtypes were defined according to the data gathered during the duration of this study in the computerized medical charts and photo archives: Egyptian, Levantine, Turkish (Anatolian), oriental Turkish (Götürks of Central Asian origin), Iraqi, Kurdish, and Persian. From 1985 to 1994, 30% of my patients were of ME origin, from 2001 to 2013 60% and since 2014 65%. Prevalence of various ethnic origins among the patients seeking for rhinoplasty in Sweden was studied. Most frequently represented ethnic groups were quoted in the order of largest prevalence: Assyrians, Iraqis, Kurds, and Iranians. Technical peculiarities concerning surgery on the various ethnic groups were described.

CONCLUSION

Noses of Middle Eastern populations exhibit some similarities, but also broad phenotypic variation. Consequently, there is no single typical Middle Eastern nose, although large size, prominent arched dorsum, and a naso-labial angle ≤90° are common.