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PREOPERATIVE DIAGNOSIS:
- Nasal obstruction secondary to external/internal valve collapse, turbinate hypertrophy, residual deviated septum, following septorhinoplasty.
- Residual Deviated septum
- Turbinate hypertrophy
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 internal valve collapse with placement of bilateral extended spreader grafts.
- Repair of nasal vestibular stenosis with reconstruction of shortened, over-rotated caudal septum with placement of columellar strut.
- Revision Septoplasty.
- Repair of nasal vestibular stenosis with reconstruction of external valve collapse due to malpositioned lower lateral cartilages with repositioning lower lateral cartilages.
- Repair of nasal vestibular stenosis with reconstruction of external valve collapse due to rim weakness with placement of bilateral conchal composite grafts.
- Harvest of bilateral concha cymba composite grafts.
- Bilateral Turbinoplasty
- Revision Septorhinoplasty (Secondary)
FINDINGS:
Narrow right greater than left external valve; Grafts harvested from rib, bilateral narrow middle vault, septum deviated to right (and caudal), recurvature of lower lateral cartilage (LLC), 8 mm short LLC, malpositioned LLC; small, thin columellar strut removed; left greater than right alar rim narrowing/alar retraction; right greater than left lateral nasal wall/middle vault.
COMMENT:
This is a patient who wished to improve her nose structurally and functionally following a previously unsuccessful rhinoplasty (different surgeon). Post-operative photos reveal an improved nose and patient has reported better breathing. Patient continues to heal.
