Key Points in Subperichondrial-Subperiosteal Dissection

Genç, Bülent; Akkuş, Ali Murat; Çakır, Barış

doi:10.1016/j.fsc.2020.09.002

Cited by 5 publications

(4 citation statements)

References 4 publications

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“…The meticulous procedures required for complete subperichondrial dissection compared with the traditional subsuperficial musculoaponeurotic system approach demand a learning curve and longer dissection time, especially in patients with weak and hypoplastic LLC, as observed in Asian populations. 1,3,4 As a consequence, surgeons may develop musculoskeletal discomfort and even injury, making surgical ergonomics and a clear magnified surgical view important considerations. 5 The prevalence of musculoskeletal pain among plastic surgeons is estimated to be as high as 78.3%-94%.…”

Section: Discussionmentioning

confidence: 99%

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Use of a Surgical Microscope for Subperichondrial–Subperiosteal Dissection in Preservation Rhinoplasty: Ergonomic Considerations

Hattori

Uda

Sugawara

2022

Plastic and Reconstructive Surgery - Global Open

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Summary Preservation of anatomical components in rhinoplasty has gained increasing popularity over recent years. Given that elevation of the soft tissue envelope in a continuous subperiochondrial–subperiosteal dissection preserves soft tissues, vessels, nerves, and lymphatics, this procedure may result in faster healing time and less swelling and scarring. However, the technique requires a learning phase and can be challenging to perform because it typically requires meticulous dissection under surgical loupes. The dissection may thus be time-consuming and a burden for surgeons, especially in secondary rhinoplasty cases. Further, the potential risk of musculoskeletal discomfort and injury to the surgeon should not be overlooked; consideration for surgical ergonomics is needed to prevent injuries and enhance surgical performance. To address these issues, we propose the use of a surgical microscope for subperiochondrial–subperiosteal dissection in preservation rhinoplasty. A microscope enables clear visualization of the surgical field and allows surgeons to make precise and delicate manipulation maneuvers. Moreover, it may also enable surgeons to maintain an ideal ergonomic posture and neutral positioning of their joints, thereby reducing physical strain. A surgical microscope may thus be a useful tool for subperiochondrial–subperiosteal dissection by providing clear visualization of the surgical field and improved surgical ergonomics for surgeons.

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Section: Discussionmentioning

confidence: 99%

“…However, this technique requires a learning phase and can be challenging because it typically requires meticulous dissection under surgical loupes. 3 , 4 The dissection can thus be time-consuming and a burden especially for less-experienced surgeons. There is also potential risk for musculoskeletal discomfort and injury to surgeons.…”

Section: Introductionmentioning

confidence: 99%

Use of a Surgical Microscope for Subperichondrial–Subperiosteal Dissection in Preservation Rhinoplasty: Ergonomic Considerations

Hattori

Uda

Sugawara

2022

Plastic and Reconstructive Surgery - Global Open

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“…There are some articles regarding the sub-perichondral dissection of de LLC and the ULC where the authors conclude that there is less postoperative oedema, less numbness and a quicker recovery time, (8) less fibrosis and bleeding (9), as well as less surgical damage to soft tissues (10).…”

Section: Nasal Septum Sub-laminar Dissectionmentioning

confidence: 99%

“…This is probably because we accept as a rule that the subperichondral should be the exclusive dissection plane. [5][6][7] There are some articles regarding the subperichondral dissection of the lower lateral cartilage (LLC) and the upper lateral cartilage where the authors conclude that there is less postoperative edema, less numbness and a quicker recovery time, 8 less fibrosis and bleeding, 9 as well as less surgical damage to soft tissues. 10 However, when we expose the cartilage, without the perichondrium protection, it becomes more fragile at the time of manipulation, as has also been observed in the LLCs in nasal tip surgery.…”

Section: Nasal Septum Sublaminar Dissectionmentioning

confidence: 99%

Cable and Mirror Sutures and the Nasal Septum Sublaminar Dissection

Neves

Martin

2023

Facial Plast Surg

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Managing the nasal septum position is crucial in septorhinoplasty. The analysis and the preparation of the anterior nasal spine and the quadrangular cartilage as well as the strategy defined to efficiently stabilize the septum will dictate considerably the success of the result. Moreover, what we see in the surgical table can suffer modifications during the healing process because of poor fixation or the cheese-wire effect of the cartilage. We will present a logical sequence and tools to achieve a proper and stable position of the nasal septum and the nasal pyramid. The sub-laminar (supra-perichondral) dissection of the quadrangular cartilage as an option to the sub-perichondral one and the use of cable and mirror sutures to three-dimensionally positioning and stabilizing the nasal septum will be described.

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Invited Discussion on: Prevention of Nasal Deviation Related to Preservation Rhinoplasty in Nondeviated Noses using Suturing Approaches

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2021

Aesth Plast Surg

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Key Points in Subperichondrial-Subperiosteal Dissection

Cited by 5 publications

References 4 publications

Use of a Surgical Microscope for Subperichondrial–Subperiosteal Dissection in Preservation Rhinoplasty: Ergonomic Considerations

Use of a Surgical Microscope for Subperichondrial–Subperiosteal Dissection in Preservation Rhinoplasty: Ergonomic Considerations

Cable and Mirror Sutures and the Nasal Septum Sublaminar Dissection

Invited Discussion on: Prevention of Nasal Deviation Related to Preservation Rhinoplasty in Nondeviated Noses using Suturing Approaches

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