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Quantitative Study of Nasal Tip Support and the Effect of Reconstructive Rhinoplasty
Holger G. Gassner, MD;
William J. Remington, MD;
David A. Sherris, MD
Arch Facial Plast Surg. 2001;3:178-184.
Objectives To develop a method to quantify nasal tissue resilience, to establish
the normal range for persons without nasal obstruction, and to measure the
changes in tissue resilience resulting from standard open rhinoplastic techniques.
Methods A new device is described that determines nasal tissue resilience. Measurements
on the nasal tip were obtained in triplicate at 5 distinct anatomical sites.
Normal values (N = 60) were stratified for both sexes into 3 different age
groups. Preoperative and postoperative measurements were also obtained in
6 patients who underwent open rhinoplasty for airway obstruction. One patient
who underwent intranasal valve repair was included for comparison. All operative
patients underwent preoperative and postoperative rhinomanometric measurements.
Results Across all age and sex groups the anterior septal angle is the firmest
area of the nasal tip. The mean tissue resilience over the interdomal area
and the midcolumella is significantly greater in men than in women. The resilience
of the interdomal area exhibits an age effect, with decreasing stiffness over
time. The postoperative changes seen correlate well with the placement of
structural grafts during rhinoplasty.
Conclusions Nasal tip support can be quantified. Normative values have been established,
which allow one to identify areas of inadequate tip support in persons with
nasal obstruction. Alterations in tip support resulting from surgical intervention
can be quantified. Open rhinoplasty techniques are an excellent tool to restore
deficiencies in nasal tip support.
From the Division of Facial Plastic Surgery, Department of Otorhinolaryngology,
Mayo Clinic, Rochester, Minn (Drs Gassner and Sherris). Dr Remington is in
private practice in Minneapolis, Minn. The authors have no commercial, proprietary,
or financial interest in the products or companies described in this article.
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