Cartilage Z plasty on lateral crus for treatment of alar cartilage malposition

Öktem, Fatih; Tellioğlu, Ali Teoman; Menevşe, Gülsüm Tetik

doi:10.1016/j.bjps.2009.01.076

Cited by 16 publications

(15 citation statements)

References 10 publications

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“…In Oktem et al (15), cartilage Z plasty was performed on the lateral crus of the alar cartilage to treat malposition; they concluded that alar cartilage malposition was successfully corrected in patients with aesthetic and functional improvements (15). However, our study has two significant differences from the Oktem et al study.…”

Section: Discussioncontrasting

confidence: 54%

“…Some authors have resected the malpositioned lateral crus and replaced it as a free graft in a more caudal position (2,17). Others have used an extra cartilage graft, placed caudally below the malpositioned lateral crus in the alar rim (1); however, when a rigid cartilage graft is placed along the interior of the alar rim, the ala may not adapt to the nasal muscles (15). Our technique does not impede fine movements of the posterior alar rim because the transposed cartilage segment supports only the anterior part of the alar rim, as in normal anatomy.…”

Section: Discussionmentioning

confidence: 99%

“…Malposition of the lateral crura not only causes functional problems, but also leads to aesthetic problems such as broad and bulbous nasal tip with parenthesis deformity. In addition, when there is a malposition of the lateral crura, conventional cephalic excision of the lateral crura can exaggerate both functional and aesthetic problems (15).…”

Section: Discussionmentioning

confidence: 99%

“…According to previous studies on alar cartilage malposition (4)(5)(6), cephalically positioned alar cartilages show a variety of characteristics including long alar creases, boxy (7) and ball-shaped nasal tip (8), parenthesis tip deformity and, finally, external valvular incompetence (9)(10)(11). Previous studies have suggested techniques to correct cephalic malposition (12)(13)(14)(15), but the gold standard is still lateral crural strut graft (Gunter graft) (16); however, many patients experience problems after this technique. In the present study, the efficacy of the repositioned lateral crural flap in correcting cephalic malposition of lateral crura was evaluated, and the cosmetic and functional results are discussed and compared with previous studies.…”

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confidence: 99%

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Repositioned lateral crural flap technique for cephalic malposition in rhinoplasty

2015

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Background Cephalic malposition of the lower lateral cartilage (CMLLC) is a relatively common anatomical variant, particularly in Middle Eastern patients. The characteristics of CMLLC include long alar creases, a boxy and ball-shaped nasal tip, parenthesis tip deformity and external valvular incompetence. The gold standard for correcting CMLLC is the lateral crural strut graft (Gunter graft), but many patients experience problems after this technique. Objective To evaluate the efficacy of the repositioned lateral crural flap (RLCF) technique in correcting CMLLC, and to discuss the cosmetic and functional results. Methods In the present study, 123 primary septorhinoplasty operations using the RLCF technique were performed between May 2012 and March 2013. The mean follow-up period was 11.4 months (range nine to 24 months). Four parameters were measured and compared pre- and postoperatively: the angle between the line connecting the maximum convexity of the lower lateral cartilage (LLC) to the tip-defining point and midline on each side (angle of rotation); the total distance between the maximum convexity of LLC right and left to midline (representing the size of the parenthesis deformity); satisfaction scale rating of the patients' nasal tip appearance; and the satisfaction scale rating of patients' breathing through their nostrils. Results The mean angle of the LLC to the midline significantly increased and the mean distance between the maximum convexities was significantly reduced, indicating correction of the malposition and reduction of the parenthesis deformity, respectively. The mean satisfactory scale ratings of nasal tip appearance and breathing quality were also significantly improved. Conclusion CMLLC can be corrected using the RLCF technique, resulting in both aesthetic and functional improvements.

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Repositioned lateral crural flap technique for cephalic malposition in rhinoplasty

2015

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“…Gunter and Friedman 24 described the use of lateral crural strut grafts with or without lateral crural repositioning to address cephalic positioning of the lateral crus of the lower lateral cartilages and observed a 95.5% success rate in 88 patients studied. Oktem et al 25 described repositioning of the lateral crus with a cartilage Z-plasty technique in which the lateral crus on each side is transected and the anterior segment attached to the domes is sutured to the caudal aspect of the posterior segment, thus repositioning the majority of the lateral crus and providing more support to the external nasal valve.…”

Section: Dynamic Collapse Of the External Nasal Valvementioning

confidence: 99%