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PREOPERATIVE DIAGNOSIS:
- Nasal obstruction secondary to external/internal valve collapse, deviated septum, hypertrophic turbinates.
PROCEDURE:
- Repair of nasal vestibular stenosis with reconstruction of external valve collapse with placement of bilateral lateral crural strut grafts.
- Repair of nasal vestibular stenosis with reconstruction of tip support with placement of tongu e in groove fixation.
- Repair of nasal vestibular stenosis with reconstruction of internal valve collapse with placement of bilateral spreader grafts.
- Repair of nasal vestibular stenosis with reconstruction of left external valve collapse with placement of a left rim graft.
- Right deep temporalis fascia harvest secondary to thin skin.
- Septoplasty.
- Bilateral Turbinoplasty.
- Repair of nasal vestibular stenosis with repositioning of lower lateral cartilage secondary to vertically-oriented positioning.
Open Primary Septorhinoplasty, platelet gel application.
FINDINGS: Native 9 mm lower lateral crura (LLC), convex, firm and cephalad oriented, external valve collapse with left greater than right, right greater than left alar retraction,=2 0narrow left greater than left internal valve narrowing, hanging columella, C – shaped septal deformity with vertically-oriented LLC and weak rims.
COMMENT: This patient was having trouble breathing, and desired a hump reduction. 1 year post-operative photos reveal an improved nose. Nose is still swollen, will continue to improve.
