1. Faculdade de Medicina – UFBA
Evaluation and surgical approach to the nasal dorsum in Negroid nose: nasal osteotomies X dorsal augmentation
Liga Baiana de Cirurgia Plástica
Faculdade de Medicina – UFBA
Author: Rogério Ramos
Co-Authors: Marcelo Cunha, Válber Menezes, Marcus Barroso, Nilmar Bandeira, Cláudia Patrícia Alves, Luiza Fadul e Lucas Plácido
INTRODUCTION
The augmentation rhinoplasty is generally the choice for correction of the Negroid nose. The effect can be obtained with the use of grafts and osteotomies in selected cases, as described by Rohrich and cols 1 and Bateman and cols 2. According to most authors, autologous cartilage remains the best option for this purpose. In this study, the authors relate their experience in treatment of the nasal dorsum of the Negroid nose.
RESULTS
The majority of the patients (80%) were submitted to dorsum augmentation using the septal cartilage as donor area. Fourteen patients (31%) underwent osteotomies. Six of these patients were submitted to concomitant autologous cartilage graft in dorsum.
Grafts
CONCLUSION
The treatment of the Negroid nose must promote satisfactory modifications, however it must maintain face harmony, preserving ethic characteristics of each patient.
MATERIAL AND METHOD
The treatment of the nasal dorsum was performed in 45 patients through the use of autogenous cartilage grafts and selective osteotomies. Follow up ranged from 1 to 3 years. The indication for the osteotomies was excessive width of the nasal base. Osteotomies were only performed if the width of the nasal base were greater than 80% of the intercantal distance. If there was low projection of the dorsum and a normal or slightly widened nasal base, only cartilage graft was used. Autologous cartilage grafts were used in layers (septal and auricular) internally fixed.
DISCUSSION
The present study allows a demonstration of the anatomical characteristics of the dorsal negroid nose. It also demonstrates the importance of pre operatory diagnosis and planning, and emphasizes the need for individualization of the procedures in accordance to the degree of negroid characteristic. This study suggests that the use of autologous cartilage grafts having as donor areas nasal septum and conchal autogenous cartilage is a good option for dorsum augmentation. The need and indications to perform osteotomies are the key for a natural post operatory result.
Auricular graft only
Auricular graft and osteotomy