PREOPERATIVE DIAGNOSIS:
- Nasal obstruction secondary to
external/internal valve collapse, s/p
rhinoplasty, 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 over-rotated nose with
placement of septal extension graft.
- 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 tip support with placement of
columellar strut.
- Graft, left cartilage.
- Right deep temporalis fascia harvest.
- Revision septoplasty.
- Submucous resection of right inferior
turbinate. Submucous resection of left
inferior turbinate.
Secondary septorhinoplasty, platelet gel
application.
FINDINGS: Lower lateral
cartilage (LLC) remnant: 7 mm at widest
dimension, truncated and s/p dome division,
right weakness at external valve greater than
right at LLC and rim; over-resected anterior and
caudal septum; left greater than right narrow
middle vault, C-shaped septum with mid deviation
to right and caudal deviation to left and vomer
previously resected and bony septum intact; 3+
scar encasing tip with tip skin adhered to scar.
Ala asymmetric with left more convex than right
and right base lower than left. Hanging
ala.
COMMENT: His 7 month post-op
photos reveal a softer
nose. |
