The Alar Contour Graft: Correction and Prevention of Alar Rim Deformities in Rhinoplasty

Rohrich, Rod J.; Raniere, Joseph; Ha, Richard Y.

doi:10.1097/00006534-200206000-00051

Cited by 62 publications

(102 citation statements)

References 5 publications

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“…Alar rim grafts are used to support the external nasal valve and to correct the asymmetries of the nostrils and slight alar retractions. 15 Alar batten grafts have been found to be effective in longterm follow-up of internal and external nasal valve collapse in previous studies. 16 Toriumi 17 stated that the application of alar rim graft was not required in patients who underwent lateral crural repositioning with LCSG and stated that repositioning with LCSG supports the alar rims.…”

Section: Discussionmentioning

confidence: 94%

Aesthetic and Functional Results of Lateral Crural Repositioning

İlhan¹,

Saribas²,

Caypinar³

2015

JAMA Facial Plast Surg

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IMPORTANCE Thin or cephalically malpositioned lateral crura cause nasal obstruction by depressing nasal valves and decrease patient satisfaction with rhinoplasty as a result of nostril asymmetry and alar collapse.OBJECTIVE To demonstrate the aesthetic and functional efficacy of lateral crural repositioning with lateral strut grafting in patients with cephalic malposition of the lateral crura undergoing primary septorhinoplasty. DESIGN, SETTING, AND PARTICIPANTSWe prospectively selected 80 patients with lateral crural malposition who underwent primary septorhinoplasty performed by the same surgeon from December 1, 2013, through May 30, 2014. The surgeon measured the angle between the lateral crura and midline intraoperatively with a goniometer to confirm malposition (angle, Յ30°). Data analysis was performed from March 13 to 23, 2015. INTERVENTION All the patients underwent primary rhinoplasty with the open approach. Lateral crural repositioning with lateral crural strut graft was used in all selected patients. MAIN OUTCOME AND MEASURES Preoperative and 6-and approximately 12-month postoperative scores on the Nasal Obstruction Symptom Evaluation (NOSE) scale (range, 0-20; decreased scores indicate improved functional results) and the Rhinoplasty Outcomes Evaluation (ROE) questionnaire (range, 0-24; increased scores indicate improved aesthetic results).RESULTS Seventy-five of 80 patients were confirmed to have cephalic malposition intraoperatively. Four patients were excluded owing to selection of different surgical techniques, leaving 71 patients for analysis. The mean (SD) and median postoperative NOSE scores at 6 months (3.18 [3.12] and 2.0) and 12 months (0.39 [1.07] and 0) showed significant improvement compared with the preoperative scores (6.96 [5.10] and 7.0) (P < .01 for each comparison). The mean (SD) and median postoperative ROE scores also showed significant improvement at 6 months (21.06 [3.82] and 23.0) and 12 months (23.12 [2.09] and 24.0) compared with preoperative scores (7.03 [3.70] and 6.0) (P = .001). However, the changes from preoperative to 12-month postoperative scores (mean [SD] and median) were not significantly different between patients with normal (NOSE scores, 8.41 [4.59] and 90 to 0.28 [0.79] and 0, respectively; ROE scores, 6.97 [3.24] and 6.0 to 23.31 [1.91] and 24.0, respectively) and thin (NOSE score, 6.59 [5.09] and 8.0 to 0.11 [0.33] and 0, respectively; ROE scores, 7.76 [3.82] and 7.0 to 23.29 [1.72] and 24.0, respectively) skin types and those with thick skin types (NOSE scores, 5.52 [5.42] and 4.0 to 0.72 [1.54] and 0, respectively; ROE scores, 6.60 [4.16] and 6.0 to 22.80 [2.53] and 24.0, respectively) (P > .05).CONCLUSIONS AND RELEVANCE Lateral crural repositioning is a useful and versatile technique to achieve successful functional and aesthetic results in a 1-year follow-up. We detected no significant difference by skin type in improvement of nasal function and aesthetic satisfaction.LEVEL OF EVIDENCE 3.

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Section: Discussionmentioning

confidence: 94%

Aesthetic and Functional Results of Lateral Crural Repositioning

İlhan¹,

Saribas²,

Caypinar³

2015

JAMA Facial Plast Surg

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“…We believe it should be considered depending of the degree of ENV collapse, skin thickness and in the absence of sufficient septal cartilage for grafts. The rib cage usually supplies sufficient length as donor site for most grafts that a surgeon may use during rhinoplasty [21][22][23][24][25][26][27][28][29][30] .…”

Section: Many Surgical Options Have Been Proposed For Correctingmentioning

confidence: 99%

Modified technique to increase nostril cross-sectional area after using rib and septal cartilage graft over alar nasal cartilages

Sá¹,

Alonso²

2012

Acta Cir. Bras.

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PURPOSE: Describe a modified technique to increase nostril cross-sectional area using rib and septal cartilage graft over alar nasal cartilages. METHODS: A modified surgical technique was used to obtain, carve and insert cartilage grafts over alar nasal cartilages. This study used standardized pictures and measured 90 cadaveric nostril cross-sectional area using Autocad®; 30 were taken before any procedure and 60 were taken after grafts over lateral crura (30 using costal cartilage and 30 using septal cartilage). Statistical analysis were assessed using a model for repeated measures and ANOVA (Analysis of Variance) for the variable "area". RESULTS: There's statistical evidence that rib cartilage graft is more effective than septal cartilage graft. The mean area after the insertion of septal cartilage graft is smaller than the mean area under rib graft treatment (no confidence interval for mean difference contains the zero value and all P-values are below the significance level of 5%). CONCLUSIONS: The technique presented is applicable to increase nostril cross section area in cadavers. This modified technique revealed to enhance more nostril cross section area with costal cartilage graft over lateral crura rather than by septal graft.

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“…Multiple techniques of varying complexity have been described to treat this common and challenging problem. (1,4) The presently used techniques are associated with scar and potential formation of crust. Thus, we attempted to overcome these shortcomings by using new grafting techniques to correct alar retraction.…”

Section: Introductionmentioning

confidence: 99%

“…Typically, this deformity is caused by congenital malpositioning, hypoplasia or surgical weakening of the lateral crura with potential for both functional and aesthetic ramifications. (1) Successful correction requires precise diagnosis and meticulous planning. Multiple techniques of varying complexity have been described to treat this common and challenging problem.…”

Section: Introductionmentioning

confidence: 99%

Correction of Alar Retraction Using Various Techniques: A Case Series

Valse¹,

Muqtadir²,

Hak³

2015

jemds

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Alar retraction is one of the common problems seen in both primary and secondary rhinoplasty. Multiple techniques of varying complexity have been described to treat this common and challenging problem. (1,4) The presently used techniques are associated with scar and potential formation of crust. Thus, we attempted to overcome these shortcomings by using new grafting techniques to correct alar retraction. In this article, we describe the simplest way of correcting alar retraction by using an alar projection graft.

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The Alar Contour Graft: Correction and Prevention of Alar Rim Deformities in Rhinoplasty

Cited by 62 publications

References 5 publications

Aesthetic and Functional Results of Lateral Crural Repositioning

Aesthetic and Functional Results of Lateral Crural Repositioning

Modified technique to increase nostril cross-sectional area after using rib and septal cartilage graft over alar nasal cartilages

Correction of Alar Retraction Using Various Techniques: A Case Series

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