No abstract

Silicone implants were noted to induce calcification when inserted for a long time, causing long-term morphologic changes. This should be taken into consideration when choosing silicone implants for augmentation rhinoplasty.

, DDS; J eung-Gweon Lee, MD; In-Hyuk Chung, MD Objectives: Although a complete anatomic knowledge of the fontanelle is a prerequisite to perform a surgical antrostomy opening, little is known about the boundary, shape, and size of the fontanelle. The purpose of this paper is to determine the best site for maintaining the patency of a surgical antrostomy opening by defining the anatomic boundaries, shape, and size of the fontanelle as well as its histological structure. Materials ana-Methods: One hundred sagittally divided heads were utilized. Mucosa overlying the lateral nasal wall was carefully removed with an operating microscope under 6x magnification. In some cases, a double mucous membrane, including the posteroinferior portion of the uncinate process, was cut as a whole and embedded in paraffin. The sections were stained with H&E. Results: The boundary of the fontanelle and the location of the. natural ostium were described in detail. Eight patterns of the posteroinferior portion of the uncinate process were observed. There were three major fontanelle shapes when observed from the medial aspect to the lateral: triangular, pencil-like, and oval. The triangular type was the most common. The anterior portion of the fontanelle was shorter than the posterior when ob· served medially and was wider than the posterior portion when observed inferiorly. Conclusions: The anterior portion of the fontanelle is more prone to stenosis than the posterior portion. An antrostomy in the posterior fontanelle may be more ideal for a mid· die meatal antrostomy of the maxillary sinus.

In contrast to previous studies, our study showed that Gore-Tex samples implanted in human bodies for extended periods of time prompted ingrowth of neighboring tissues, calcified tissue degeneration, and inflammation. Foreign body reactions were found in a large number of samples. The Gore-Tex structures were destroyed and transformed. As a result, it is important to follow the stability of Gore-Tex material on a long-term basis.

Objectives:The blood supply to the nasal tip and colwnelJa was examined to determine whether it could be damaged a s a res ult of transcolumellar incision during an external rhinoplasty approach in Asians. Methods: The blood vessels that supply the n asal tip were examined by dissecting 51 cadavers, and their corresponding 102 nasal sections were in· j ected with r d latex b efore di ssection. The s ize and di stribution of the vessels were measured with the unaid d eye and the primary supply vessels were determined. The subdermal layer in which the vessels lie and the com·s of the ves els were also investigat d. R ear. tits: Th main blood upply source of the nasal tip prov d to be the lateral nasal artery in 78% (80/102) of the cases examined, while the remaining cases (22%) r ceiv d their blood supply via the dorsal nasal artery. olum llar branches we re narrow in dia me ter and varied in size and appearance, and w r e th r for appear d insufficient as a main blood supply. Th se arteries passed through the musculoapon urotic lay i·, but they we re also in close prox· imity to the main surgical plane in the dome of the lower late ral cartilage. Conclusions: The authors sp eculate that th nasal tip blood supply in Asians is primarily derived from the lateral nasal or dorsal nasal arteries, with a variable contribution from the colum Ila arteries. The refore, it is important to corr ctly d termine the surgical plane b elow the musculoaponeurotic layer in orde r to prevent skin flap necrosis or nasal tip d eformity that may occur from damage to th main vessel during an external rhino· plas ty approach.

Cartilaginous structures of Asian noses were substantially different from those of whites in terms of their shape, size, thickness, and relationship with other structures. The data from surgical anatomical observations of the cartilaginous framework of Korean cadaveric noses provided in this report will provide valuable information for performing rhinoplasty on Asian patients.

CBF increased at first, but with increasing incubation time ciliary movements decreased gradually and stopped eventually. This loss of CBF may be an irreversible change associated with ultrastructural changes in the mitochondria and the plasma membrane of the cilia.

The Asian nose has its unique morphology and forms a significant proportion of noses treated by the rhinoplasty surgeon not only in Asia but also in other countries where the Asian diaspora resides. The anatomical features and dimensions of the Asian nose differ from noses of persons of African, Caucasian, Indian, and Middle Eastern origins, poses its own challenges, and warrants a unique set of techniques for its aesthetic improvement. In this article, we present an overview of the approach to the lengthening of the Asian nose, drawing from our own experience with managing the Asian nose and referencing the published literature on the subject.