A new approach to nasomaxillary complex type of nasal bone fracture: Clip operation

Efficacy of Nostril Supportive Splint Treatment for Nasal Septum Deformities after Le Fort I Osteotomy

This retrospective study aimed to evaluate the efficacy of support splint treatment for deformities and deviations of the nasal septum after Le Fort I osteotomy (LFI). Patients were divided into two groups: the retainer group wore a nasal support splint immediately after LFI for 7 days, and the no retainer group did not wear a nasal support splint. Evaluation was performed by measuring the ratio of the difference between the left and right sides of the nasal cavity area (ratio of nasal cavity) and the angle of the nasal septum using three computed tomography frontal images (anterior, middle, and posterior) before and one year postoperatively. Sixty patients were included and divided into two groups, the retainer and no retainer group (n=30 each). Regarding the ratio of nasal cavity on middle images at one year postoperatively, the retainer and no retainer groups differed significantly (0.79±0.13 and 0.67±0.24, respectively; P =0.012). The angle of the nasal septum on anterior images at one year postoperatively was 164.8±11.7° in the retainer group and 156.9±13.5° in the no retainer group, showing a significant difference ( P =0.019). This study suggests that support splint treatment after LFI is effective in preventing post-LFI nasal septal deformation or deviation.

Three-Dimensional Arterial Distribution Over the Midline of the Nasal Bone

BACKGROUND

A comprehensive understanding of arterial variations around the midline of the nose is of great importance for the safety of filler injection.

OBJECTIVES

The aim of the study was to clearly define the 3-dimensional location of the arteries along the midline of the nasal bone.

METHODS

The arterial structures overlapping the nasal bone along the midline were observed in 79 cadavers.

RESULTS

The present study found that 0 to 3 named arteries per nose segment could be identified. All the arterial structures were located in or above the superficial musculoaponeurotic system layer overlapping the nasal bone. The probability of encountering named arteries at 5 defined points, P1 to P5, was 5/79 (6.3%), 4/79 (5.1%), 1/79 (1.3%), 6/79 (7.6%), and 9/79 (11.4%), respectively. The depth of the main arterial trunk was 1.2 ± 0.4 mm, 1.6 ± 0.6 mm, 1.8 ± 0 mm, 1.0 ± 0.4 mm, and 0.9 ± 0.5 mm below the skin at P1 to P5, respectively.

CONCLUSIONS

The authors confirmed that sub-superficial musculoaponeurotic system injection along the midline through a needle is anatomically reliable and that a technique with 1 entry point through the rhinion via a cannula can easily keep the needle sufficiently deep for safe nasal filler injection.

A Safer Non-surgical Filler Augmentation Rhinoplasty Based on the Anatomy of the Nose

BACKGROUND

Filler augmentation rhinoplasty is a quick, non-surgical procedure that can produce outcomes comparable to open rhinoplasty surgery. However, the increased frequency of vascular complications has emerged as an important issue. The present study aimed to investigate measures to overcome the vascular complications based on the anatomy of the nose.

METHODS

A colored filler was injected into cadavers for augmentation of the nasal dorsum using the retrograde injection technique and direct percutaneous injection technique. The concavity of the sellion area was measured using lateral view cephalography X-ray images. Lastly, we used ultrasonography to determine filler location in 20 Korean patients who had filler injected into the sellion area by injection at the infratip lobule.

RESULTS

Filler was injected into the superficial layer by the retrograde injection technique in three cadavers and into the deep layer by direct percutaneous injection technique in another three cadavers. The average angle between the nasal dorsum skin and sellion was found to be 10.2 ± 2.8 degrees, while the minimum angle was 5.1 degrees. The average distance between the needle tip and nasal bone was 1.9 ± 0.3 mm, while the minimum distance was 0.4 mm.

CONCLUSIONS

When performing filler augmentation rhinoplasty on the sellion area, direct percutaneous injection from the glabella can allow more accurate injection into the supraperiosteal level, which can reduce complications such as visual loss and skin necrosis due to vascular compromise.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .