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PREOPERATIVE DIAGNOSIS:
- Nasal obstruction secondary to external/internal valve collapse, deviated septum and 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 columellar strut.
- Repair of nasal vestibular stenosis with reconstruction of internal valve collapse with placement of bilateral spreader grafts.
- Repair of nasal vestibular stenosis with repositioning of lower lateral cartilage secondary to vertically-oriented positioning.
- Right deep temporalis fascia harvest
- Septoplasty.
- Bilateral Turbinoplasty.
- Open Primary Septorhinoplasty, platelet gel application.
FINDINGS: Native 9 mm lower lateral crura (LLC), concave (left greater than right) and cephalad oriented, external valve collapse with left greater than right, left alar retraction, narrow internal valve left greater than right, 3+ C – shaped septal deformity (convex to right) with 3+ left spur; right dome higher than left dome; wide caudal lateral nasal right bone; low and deep radix.
COMMENT: This patient wished to improve his profile and was having difficulty breathing. Post-operative photos reveal an improved nose. Better breathing has been reported as well.
