No abstract

No abstract

Objectives: It is extremely difficult to obtain ideal tip projection and nose lengthening by septal extension graft using only septal cartilage in Asians, because their nasal septal and alar cartilages are small and weak. Therefore, we introduce a new septal extension graft using a cartilage–bone complex with the vomer and the perpendicular plate of the ethmoid bone as well as cartilage to obtain optimal outcomes. Methods: Participants included 30 patients who underwent surgery by external approach. The septal cartilage, vomer, and perpendicular plate of the ethmoid bone harvested by septoplasty were used. There were 2 layers of cartilage on each side and bone in between to create a strong cartilage–bone complex for projection and lengthening. The bony portion was placed in the tip side, and the double-layered cartilage portion was placed in the inferior portion of the caudal septum of the L-strut to create powerful fixation. Results: There were statistically significant improvements in nasal length (4.71 ± 0.65 vs 5.15 ± 0.53 cm, P value <.0001), tip projection (2.66 ± 0.40 vs 3.18 ± 0.42, P value <.0001), and nasolabial angle (94.0° ± 9.3° vs 107.2° ± 9.6°, P value <.0001) postoperatively. All patients were subjectively satisfied, and 2 different surgeons had excellent or good opinions in 28 (94%) patients. Conclusions: The sandwich technique using cartilage and bone complex results in satisfactory outcomes with stronger tip support, especially in Asians with a weak nasal tip who desire ideal tip projection and dramatic change.

Supplemental Digital Content is available in the text.

Background: Autologous adipose-derived stromal vascular fraction treatments have been shown to elicit antiinflammatory, antifibrotic, immunomodulatory, angiogenic, and regenerative effects. Injections of adipose-derived stromal vascular fraction have been used to treat severely scarred tissues. Methods: Revision septorhinoplasty was performed in 40 patients with severely contracted noses. Clinical outcomes and adverse events were compared between one group of patients treated with adjuvant adipose-derived stromal vascular fraction injections and a control group of patients treated with adjuvant 0.9% preservative-free saline injections. Results: In the adipose-derived stromal vascular fraction group, nasal lengths were estimated at 4.2 ± 0.2 cm at baseline to 5.1 ± 0.2 cm at 18 months after revision septorhinoplasty. The lengths of nasal tip projection improved from 2.2 ± 0.2 cm at baseline to 2.9 ± 0.1 cm 18 months after surgery. In addition, nasofrontal angles improved from 125.6 ± 5.1 degrees at baseline to 128.1 ± 4.8 degrees 18 months after surgery. Nasolabial angles in the adipose-derived stromal vascular fraction group were estimated at 105.8 ± 6.5 degrees at baseline and 94.9 ± 5.6 degrees 18 months after surgery. Of these, nasal length, nasal tip projection, and nasolabial angle, but not nasofrontal angle, values improved more in the adipose-derived stromal vascular fraction group than in the control group. Conclusion: Preoperative and postoperative adjuvant adipose-derived stromal vascular fraction treatment markedly improved the therapeutic outcomes of revision rhinoseptoplasty of severely contracted noses without major side effects. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Poly(ether ester) elastomers (PEEs) were synthesized in which dimethyl terephthalate (DMT) was the primary diester compound in the hard segment (H/S) and dimethyl 2,6-naphthalene dicarboxylate (NDC), which has a more rigid aromatic chemical structure than DMT, was the secondary diester in the H/S. The block PEEs with poly(tetramethylene terephthalate) (PTMT) and/or poly(tetramethylene 2,6-naphthalate) (PTMN) as the H/S and poly(tetramethylene ether glycol terephthalate) (PTMEGT) as the soft segment (S/S) were synthesized through transesterification and polycondensation of DMT, NDC, 1,4-butanediol (BD), and poly(tetramethylene ether) glycol (PTMEG) of molecular weight 1000. The melting temperature and heat of fusion of the PEEs decreased with increasing NDC content up to an NDC content of 44.4% in the H/S, but increased on further increase of the NDC content. In addition, the higher the fraction of NDC in the H/S, the higher the glass transition temperature of the copolymer. X-ray diffraction analysis revealed that the crystallinity of the sample decreases as the NDC content in the H/S is increased relative to that of DMT. Increasing the PTMN content in the H/S reduced the effect of UV photodegradation on the elongation at break. The results show that the introduction of the NDC component into the H/S as a secondary diester compound improves the UV resistance of the resulting PEE.

Background and ObjectivesZZQuality of life is one of the important issues in the treatment of patients with chronic diseases of the nose and sinuses. Psychological disturbance may affect patient's symptoms and the outcome after treatments. In this study, we aimed to evaluate both sinonasal and psychological profiles in rhinologic patients.Subjects and MethodZZFrom February 2007 to January 2008, 117 rhinologic patients who had been scheduled for the nasal and sinus surgery were enrolled. They were divided into two groups, nasal cavity disease (NCD, n=53) and chronic rhinosinusitis (CRS, n=64). Somatic and psychological symptoms were evaluated using the Sinonasal Outcome Test-20 (SNOT-20) and Symptom Checklist-90-Revised (SCL-90-R). All of the patients underwent nasal endoscopy, computed tomography, acoustic rhinometry, T&T olfactometry and allergic skin prick test.ResultsZZGlobal severity index of the SCL-90-R was within the normal range for all the rhinologic patients. There was no difference of ) and SCL-90-R (p=0.367) scores between the two groups. In the non-allergic patients, the CRS group had higher scores of SNOT-20 (p=0.002) and SCL-90-R (p=0.003) compared to the NCD group. The allergic NCD patients showed significantly higher scores of SNOT-20 (p=0.020) and SCL-90-R (p=0.003) compared to non-allergic NCD patients.ConclusionZZAllergy could augment the patient's somatic and psychological symptoms, especially in the NCD group. Therefore, allergy control may be important in the management of patients with nasal cavity diseases if they have allergic rhinitis.

Background Aesthetic physicians and surgeons should consider differences in anthropometric and anatomical characteristics between Asians and Caucasians in performing facial rejuvenation procedures using absorbable threadlifts in Koreans. Objectives This paper was prepared to propose empirical treatment protocols for Korean aesthetic physicians and surgeons. Methods A panel of five Korean experts on the aesthetic uses of an absorbable polydioxanone (PDO) monofilament threadlift (Mint Lift®; HansBiomed Co Ltd., Seoul, Korea), thus termed as “the Mint Consensus Group,” was convened to recommend practical guidelines for empirical treatment with the Mint Lift®. Results To summarize, our recommendations are as follows: First, the entry and exit points should be determined considering anatomical characteristics of the face (Level of evidence III). Second, treatment procedures may vary depending on indications (Level of evidence III). Conclusions Here, we propose empirical treatment protocols for facial rejuvenation using a novel absorbable PDO monofilament threadlift in Koreans. But more evidence-based efforts should be made to update the current treatment protocols.