Nasal Soft Tissue Research Articles

Nasomaxillary effects of miniscrew-assisted rapid palatal expansion and two surgically assisted rapid palatal expansion approaches

This retrospective study was performed to evaluate nasomaxillary changes in 36 patients at an advanced stage of skeletal maturity who underwent miniscrew-assisted rapid palatal expansion (MARPE) or surgically assisted rapid palatal expansion (SARPE) with/without an alar base cinch. Cone beam computed tomography images taken before and after expansion were analysed. Changes in the width of the dental arch (D66S, D66I), maxillary base (MxMol), and nasal floor and nasal cavity in the molar and canine regions (NaFMol, NaFCan, NaCMol, NaCCan) were compared, as well as changes in the choanal aperture (CA) and nasal soft tissue (NW). The MARPE technique produced smaller dental changes (D66S; P=0.025) and greater nasomaxillary expansion (MxMol, P=0.010; NaCMol, P=0.016; NaCCan, P=0.017; NaFMol, P=0.001; CA, P=0.002) than both SARPE techniques. Changes in NW did not differ significantly between the groups (P=0.200). MARPE uniformly increased the anterior and posterior widths of the nasal cavity. SARPE expanded the nasal cavity in a ‘V-shape’ pattern. Changes in the nasal cavity and choanal aperture related to the amount of dental arch expansion were greater for MARPE than for SARPE. All three approaches increased the width of the nasal soft tissue, although the cinch in SARPE limited this increase.

Nose Reconstruction Using Local and Regional Flaps: The Challenges and Advantages.

Background:Nose is a central structure in midface. It has an important function in maintaining the aesthesis of the face. The three-dimensional (3D) structure of the nose is challenging to reconstruct. However, the availability of abundant vascularity and surrounding tissue is advantageous for the reconstruction of the soft tissue. Hence, this study was carried out to assess the cosmetic outcome and acceptability of patients undergoing nasal soft tissue reconstruction using local and regional flaps.Materials and Methods:Patients undergoing nasal soft tissue reconstruction using local or regional flaps, between January 2017 and December 2018, were studied. Patients requiring free flaps or skin grafts for reconstruction were excluded from the study. All the patients during follow-up at 3–6 months were asked to rate cosmetic acceptability and donor site cosmesis as bad, good, and very good.Results:In this study, 15 cases of nasal soft tissue reconstruction were studied. Among the 15 cases, 9 (60%) were male and 6 (40%) were female; the age range of patients was 7–65 years. Majority of the patients (5, 33.3%) had trauma as major cause of deformity. Post malignancy excision defect was the next major cause. All patients were happy with the results, only patient with composite graft complained regarding hyperpigmentation.Conclusion:Nose is an important structure in the midface. Apart from olfaction and respiration, maintaining adequate cosmesis is also an important function of the nose. Any deformity of the nose can be devastating to the patient. But, the 3D structure with varied structures makes reconstruction challenging to recreate. However, the availability of adequate donor tissue in local and surrounding region makes it advantageous. If principles of reconstruction are followed strictly, the outcome is good. Tissue expansion can be used whenever soft tissue requirement is more.

Short-term and long-term effects of rapid maxillary expansion on the nasal soft and hard tissue.

To evaluate nasal soft and hard tissue changes immediately post-rapid maxillary expansion (RME) and to assess the stability of these changes using cone beam computed tomography (CBCT). A total of 35 treatment group (TG) patients (18 girls, 17 boys; 9.39 ± 1.4) had a pre-RME CBCT and a post-RME CBCT approximately 66 days after expansion, and 25 patients had a follow-up CBCT 2.84 years later. A total of 28 control group (CG; no RME) patients (16 girls, 12 boys; 8.81 ± 1.6) had an initial CBCT and a CBCT an average of 2.25 years later. Soft and hard tissue nasal landmarks were measured in transverse, sagittal, and coronal planes of space on CBCT scans. Differences within the same group were evaluated by paired t-tests or Wilcoxon signed-rank tests. Long-term comparisons between TG and CG were evaluated by independent-sample t-tests or Wilcoxon rank-sum tests. Immediately post-RME, there were statistically significant mean increases of 1.6 mm of alar base width, 1.77 mm of pyriform height, and 3.57 mm of pyriform width (P < .05). CG showed the significant increases over 2.25 years (P < .001). Compared with CG, the long-term evaluation of TG demonstrated only pyriform height and pyriform width showed a statistically significant difference (P < .01). Although RME produced some significant increase on the nasal soft tissue immediately after expansion, it regressed to the mean of normal growth and development over time. However, long-term evaluation of TG compared with CG showed only pyriform height and pyriform width to be affected by RME.

Cannula versus needle in medical rhinoplasty: the nose knows.

The use of hyaluronic acid (HA) fillers has become a popular alternative for nose remodeling, although poor understanding of the nasal anatomy has resulted in adverse events and generated some controversy. Among them, is the question of where and when to use cannulas vs needles. Through multiple cadaver dissections, clinical experience and the review of medical literature the authors conclude the use of needle over cannula is preferred, assuring a correct injection plane lying fully against the bone or cartilage. Although blunt in nature, cannulas may lead to difficulty in determining with precision the exact depth of product placement and contribute to more dissection of adjacent structures. Thorough knowledge of the highly variable nasal anatomy, including vessel depth location is of outmost importance in avoiding adverse events. Good patient selection is critical where most noses for augmentation rhinoplasty and some reduction rhinoplasty candidates where the goal is to camouflage the dorsal hump are amenable to medical rhinoplasty, unless there is reduced skin elasticity of nasal soft tissues or distortion of anatomy from surgery or trauma. Appropriate product selection is important for effective results. The authors suggest fillers with low cohesivity and high lifting capacity. Finally, we suggest a technique referred as Rhinosculpting base in the use the use of three conceptual elements: facial analysis, light reflection, and use of HA gel as a cartilage graft, in combination with the detailed injection technique presented in this article, which ensures a safer and satisfying treatment outcome.

Rhinophyma: Prevalence, Severity, Impact and Management.

Rhinophyma is an advanced stage of rosacea affecting the nasal soft tissues and resulting in disruption of the nasal architecture, airway obstruction, and disfigurement of the nasal aesthetic units. Rhinophyma presents with hypertrophy of the nasal soft tissues, erythema, telangiectasias, nodules, and lobules with a bulbous appearance. Significant psychosocial morbidity is associated with the disease. Understanding of this disease has improved and multiple treatment options exist. The article is a review of the literature to evaluate the pathophysiology, clinical presentation, and epidemiology of keywords “rhinophyma” and “rosacea” using an OVID Medline and PubMed search along with a systematic review of outcomes pertaining to treatment of rhinophyma with laser therapy, scalpel excision, and the subunit method using an OVID Medline search. The subunit method has the highest complication and revision rates followed by carbon dioxide laser therapy. Outcomes between carbon dioxide laser and scalpel therapy and electrocautery are equivalent. Scalpel excision is a more cost-effective treatment modality with less post-operative complications; however, it risks poor hemostasis intraoperatively. Patient satisfaction is common post-therapy regardless of the treatment method. Over 89% of patients would recommend undergoing treatment for rhinophyma irrespective of treatment type. Treatment options vary, and choice of treatment can be dependent on practitioner and patients’ treatment goals.

Predicting Nasal Soft Tissue Envelope Thickness for Rhinoplasty: A Model Based on Visual Examination of the Nose.

Predicting nasal soft tissue envelope (STE) thickness is an important component of the preoperative evaluation for rhinoplasty that presently lacks validated tools. Assess for patient facial features and factors that can help predict nasal STE thickness. Retrospective review and prospective assessment conducted at an academic tertiary referral center. This study included 190 adult patients and four expert raters. The patients had high-resolution maxillofacial CT scans and standardized facial photographs on file and did not have a history of nasal fracture, septal perforation, rhinoplasty, or other surgery or medical conditions altering nasal form. Assess each face for features that could help predict nasal STE thickness: sebaceous quality of skin, visibility of nasal tip cartilages, presence of freckles, presence of telangiectasias, Fitzpatrick skin type, patient age, sex, and body mass index (BMI). Measure actual nasal STE thickness using high-resolution CT scans. Analyze which facial features and patient factors help predict nasal STE thickness. Pearson correlations were calculated between actual nasal STE thickness and patient facial features and factors. These showed that more sebaceous skin, telangiectasias, higher Fitzpatrick skin type, male sex, and higher BMI were associated with a thicker nasal STE. Increased visibility of nasal tip cartilages, freckles, lower Fitzpatrick skin type, female sex, and lower BMI were associated with a thinner nasal STE. There are patient facial features and factors that can help surgeons predict nasal STE thickness before rhinoplasty. An accurate prediction of nasal STE thickness can improve preoperative planning for rhinoplasty, allowing implementation of pre-, intra-, and post-operative treatments to optimize the nasal STE, which may ultimately improve patient outcomes and satisfaction.

A Three-Dimensional Study of the Nasolabial Soft Tissue Symmetry in Children With Unilateral Complete Cleft Lip and Palate Using Traditional and Split-Type Nasoalveolar Molding.

Presurgical nasoalveolar molding (NAM) is the most common preoperative treatment for cleft lip and palate. However, NAM may have some limitations such as requiring high technical sensitivity and frequent visits. To simplify the device, some scholars have changed the traditional NAM into a split-NAM consisting of a alveolar molding plate and a nasal hook. This study compared the shaping effect of split NAM and traditional NAM on nasolabial soft tissue using three-dimensional (3D) measurement. A total of 39 patients with unilateral cleft lip and palate (UCLP) were enrolled and divided into 2 groups. 13 patients were treated with split-NAM while the other 26 patients were treated with traditional NAM. 3D images of all patients' craniofacial soft tissue before and after NAM treatment were recorded and measured by three-dimensional software. Statistical analysis of measurements in both groups was performed using SPSS software. After treatment, nasal soft tissue symmetry in the split-NAM group was better improved than that in the NAM group in vertical and anterior-posterior direction, but was worse improved in transverse direction. There was no significant difference in labial soft tissue symmetry between two groups. The split NAM can better elevate the alar and nostrils of the cleft side, and have a better forward effect on alar outer edge, nasal base, and nostrils. However, the traditional NAM can better reduce the width of nasal base.

Aesthetic reconstruction in subtotal nasal defect following excision of basal cell carcinoma with bilateral nasolabial flaps: A case report

The use of nasolabial flap to reconstruct nasal soft tissue defects is one of the ancient methods for reconstruction in the medical literature. Over time different modifications have been introduced to expand its usage. Here, we present a case of basal cell carcinoma of the nose for which wide local excision and reconstruction of the subunit was done using bilateral nasolabial flaps.

Short-term impact of microimplant-assisted rapid palatal expansion on the nasal soft tissues in adults: A three-dimensional stereophotogrammetry study.

ObjectiveThe aim of this study was to evaluate changes in the nasal soft tissues, including movements of landmarks, changes in linear distances, and volumetric changes, using three-dimensional (3D) stereophotogrammetry after microimplant-assisted rapid palatal expansion (MARPE) in adult patients.MethodsFacial data were scanned using a white light scanner before and after MARPE in 30 patients. In total, 7 mm of expansion was achieved over a 4-week expansion period. We determined 10 soft tissue landmarks using reverse engineering software and measured 3D vector changes at those points. In addition, we calculated the distances between points to determine changes in the width of the nasal soft tissues. The volumetric change in the nose was also measured.ResultsAll landmarks except pronasale and subnasale showed statistically significant movement on the x-axis. Pronasale, subnasale, alar right, and alar left showed significant movement on the y-axis, while all landmarks except subnasale showed significant movement on the z-axis. The alar base width, alar width, and alar curvature width increased by 1.214, 0.932, and 0.987 mm, respectively. The average volumetric change was 993.33 mm3, and the amount of increase relative to the average initial volume was 2.96%.ConclusionsThe majority of soft tissue landmarks around the nasal region show significant positional changes after MARPE in adults. The nose tends to widen and move forward and downward. The post-treatment nasal volume may also exhibit a significant increase relative to the initial volume. Clinicians should thoroughly explain the anticipated changes to patients before MARPE initiation.

Evaluation of nasal soft tissue changes in orthognathic surgery patients with 3-Dimensional (3D) photographic method

Evaluation of nasal soft tissue changes in orthognathic surgery patients with 3-Dimensional (3D) photographic method

Intraoperative use of electrolysis for hair removal in paramedian forehead flap

Hair transfer from the forehead hairline to the nasal tip leads to frequent patient complaints and can be challenging to deal with after paramedian forehead flaps (PFFs). To prevent it, flap design can be changed from vertical to an oblique fashion, providing a more prolonged and hairless flap. 1 Faris C. van der Eerden P. Vuyk H. The midline central artery forehead flap: a valid alternative to supratrochlear-based forehead flaps. JAMA Facial Plast Surg. 2015; 17: 16-22 Crossref PubMed Scopus (12) Google Scholar Furthermore, when hair-bearing skin is included in the flap, some epilation can be performed from the underside of the flap at the initial flap elevation. 2 Correa B.J. Weathers W.M. Wolfswinkel E.M. Thornton J.F. The forehead flap: the gold standard of nasal soft tissue reconstruction. Semin Plast Surg. 2013; 27: 96-103 Crossref PubMed Scopus (48) Google Scholar Although such measures can sometimes be useful, hair transfer may be unavoidable and difficult to treat, especially in cases of white hair, which is not responsive to epilation lasers.

Nasal soft tissue changes after two different approaches for surgically assisted rapid maxillary expansion

The aim of the study was to evaluate the nasal soft tissue changes in patients who underwent surgically assisted rapid maxillary expansion (SARME) using two different surgical approaches. Thirty-two patients were included in the study, and divided into two groups according to the type of surgical approach: in group A (n=17), SARME performed with standard Le Fort I circumvestibular approach with alar base cinch and anterior nasal spine (ANS) exposure; and in group B (n=15) operations were performed with the same standard Le Fort I circumvestibular approach with only alar base cinch. Measurements of height and width of the philtrum, nasal and subnasal width, and columella width were taken from three-dimensional facial images obtained before surgery (T1), after the distraction phase (T2) and 6 months postoperatively (T3). The mean maxillary expansion was 7.3±0.7mm for group A and 7.5±1.5mm for group B, without any significant difference between groups (P=0.59). Both groups presented an increase in all vaules in T2 and T3. The approach used in group A resulted in smaller changes in the columella width. The results of the present study show that there is no need for intraoperative releasing of the soft tissues around the anterior nasal spine during SARME if columella width is sufficient. However, further randomized studies based on large patient groups are needed before final conclusions on this topic can be reached.

Nasal soft- and hard-tissue changes following tooth-borne and hybrid surgically assisted rapid maxillary expansion: A randomized clinical cone-beam computed tomography study

PurposeThe aim of this study was to assess the effects of tooth/bone-borne (hybrid) and tooth-borne (TB) surgically assisted rapid maxillary expansion (SARME) on the width of the nasal soft and hard tissue. Patients and methodsTwenty skeletally mature patients (nine males and 11 females; mean age 19.4 years) with transverse maxillary hypoplasia were randomly assigned to hybrid or TB devices. The patients had undergone SARME operations, performed by the same surgical team using the same procedure (Le Fort I osteotomy with pterygomaxillary dysjunction, midline osteotomy, and no down-fracture). Nasal soft- and hard-tissue changes were analyzed using CBCT preoperatively (T0), at the end of the active expansion phase (T1), and after 6 months of retention (T2). The study was approved by the relevant ethics committee. ResultsThe skeletal and soft-tissue nasal parameters increased significantly in the T0–T1 and T0–T2 periods in both groups (P < 0.05). No statistically significant differences between the groups were observed. The mean piriform aperture width increased from 1.26 mm in T0–T1 to 0.97 mm in T1–T2 and 2.17 mm in T0–T2 (P < 0.008). In the soft tissue, the alar base width increased to 2.78 mm and the alar width to 2.95 mm in T0–T2 (P = 0.001). There was a positive correlation (63.6%) between the changes in skeletal and soft-tissue values. ConclusionThe hybrid and TB devices led to similarly significant widening effects in nasal soft and hard tissues in both the short term and 6 months after SARME.

ПУНКЦИОННОЕ ЛЕЧЕНИЕ СИНУСИТОВ В УСЛОВИЯХ ЦИТОПЕНИИ У РЕЦИПИЕНТОВ ТРАНСПЛАНТАЦИИ ГЕМОПОЭТИЧЕСКИХ СТВОЛОВЫХ КЛЕТОК

Introduction: Sinusitis is one of the most common infectious complications at the stages of hematopoietic stem cell transplantation. Diagnosis and treatment patients whith cytopenia often causes difficulties for otorhinolaryngologists. Objective: To analyze the possibility of puncture of the maxillary sinuses in patients whith cytopenia after hemopoietic stem cells transplantation. Materials and methods. The case histories of 350 patients whith rhinosinusitis, who received treatment at the Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation from January 2017 to June 2018 were analyzed. Of these patients, 41 (11%) (11 – 62 y.o.) underwent puncture of the maxillary sinuses. The control group included 59 immunocompetent patients undergoing puncture treatment for sinusitis. Results: The clinical picture of sinusitis in patients with cytopenia was different from the classical one. In cases of severe anemia (&lt;80 g/l), paleness of the mucous membranes of the nasal cavity prevailed; with extremely severe neutropenia (&lt;0.5 x 109/l), and leukopenia (&lt;1.0 x 109/l) in the vast majority of patients, the nasal discharge was mucopurulent. 10% patients with drug immunosuppression and agranulocytosis have pronounced edema and hyperemia of nasal soft tissues. In 19.5% patients, who underwent puncture, severe thrombocytopenia (&lt;25 x 109/l) was observed. In 3 (7%) patients, significant bleeding was observed after puncture. In punctate we observed Str. Viridans (26.8%), Pseudomonas spp. (14.6%), and Klebsiella pneumonia (12.2%) of cases. Conclusion: Sinusitis with cytopenia is prone to atypical course. Symptoms in these conditions can vary from scanty to pronounced. Puncture of the maxillary sinuses in such patients can be performed according to indications.

Repair of nasal alar soft tissue defect with double-leaf flap

Objective To investigate the therapeutic effect of double leaf flap in repairing nasal alar soft tissue defect. Methods In 25 patients with basal cell carcinoma of nasal wing skin, the defect diameter of nasal wing soft tissue between 0.5 cm and 2.0 cm was removed and the defect was repaired with double flap immediately. Results The patients in this group were all successful in surgery. The incisions were all first-stage healing, no necrosis of the skin flap, 1 to 3 years of follow-up after surgery, no recurrence of cancer, and the repair of the skin flap was basically the same as the color and texture of the surrounding tissue. The scars were not obvious. The lateral nasal wing physiological radians were naturally smooth. Both sides were symmetrical and met the aesthetic standards of the nose. Conclusions With the advantages of simple design and simple operation, high survival rate and beautiful shape of nasal wing after repair, the double-leaf flap can be widely used in clinic. Key words: Carcinoma, basal cell; Surgical flaps; Nose; Reconstructive surgical procedures; Double leaf flap

Pediatric Nasal Traumas: Contribution of Epidemiological Features to Detect the Distinction Between Nasal Fractures and Nasal Soft Tissue Injuries.

Nasal bone is prone to injury due of its prominent position on the face. Epidemiologic surveys are necessary to investigate nasal traumas. The aim of the present study is to examine the distribution of trauma etiologies according to age, sex, and seasonality in pediatric patients who present with nasal trauma, and to classify the pathologies according to their etiology as nasal fractures or nasal soft tissue injuries. A total of 200 pediatric patients aged between 0 and 18 years who were admitted to the emergency room with sustained nasal trauma between September 1, 2015 and August 1, 2016 and who were diagnosed with an either nasal fracture or nasal soft tissue injury were retrospectively analyzed. The relationship between the nasal bone fractures and nasal soft tissue injuries and age, sex, admission date, and trauma etiology were investigated. Of 200 patients, 70.5% were males and 29.5% were females with a mean age of 8.93 ± 5.50 years. Of these patients, 33.0% were in the 0 to 5 years age group, 24.0% were in the 6 to 10 years age group, 18.5% were in the 11 to 14 years age group, and 24.5% were in the 15 to 18 years age group. Of these, 82.5% had a nasal soft tissue injury and 17.5% had a nasal fracture. The etiology of trauma was most commonly fall from a height in 42.5% of the patients. Impact injuries and falls were the most common etiologies in the 0 to 5 age group, falls were the most common etiologies in the 6 to 10 age group, sports injuries were the most common etiologies in the 11 to 14 age group, and physical assault was the most common etiology in the 15 to 18 age group (P = 0.001; P < 0.01). According to the paired comparisons, the rate of nasal fracture in the 0 to 5 age group was significantly higher than the rates in the 11 to 14 (P = 0.001) and 15 to 18 (P = 0.001) age groups (P < 0.05). The rate of nasal soft tissue injuries was significantly higher in the patients presenting to the emergency room with sustained impact injury to the nose or falls. The majority of the patients presenting with physical assault and sports injuries were males. Nasal soft tissue injuries were mostly seen in girls, whereas the rate of nasal fractures was higher in boys, which was directly proportional to the trauma etiology and severity of injury. The patients often presented in the summer season. Our study results suggest that age, sex, time of trauma, and type of trauma guide the diagnosis of specific pathologies in pediatric patients presenting with sustained trauma. These characteristics must be specifically questioned and taken into consideration in the follow-up and treatment.

The Relationship Between Hard Tissue and Soft Tissue Dimensions of the Nose in Children: A 3D Cone Beam Computed Tomography Study.

This study using three-dimensional cone beam computed tomography (CBCT) images of children determined relationships between nasal skeletal and soft tissue measurements and assessed the association with sex, age, and skeletal maturation stage. Following reliability studies, skeletal and soft tissue parameters were measured on coded CBCTs of 73 children (28M:45F;6-13yoa). Pearson and Mantel correlations were used to analyze associations between skeletal and soft tissues. Partial Mantel correlations were used to study the associations between skeletal and soft tissue, adjusting for sex, age, and skeletal maturation. Linear regression analyses were used to predict soft tissues sizes. Logistic regression was used to study the relationships between soft and skeletal tissue symmetry. Except for nasal aperture width and interalar width, skeletal landmarks best predicted corresponding soft tissue landmarks. Significant positive associations existed between skeletal and soft tissues after adjusting for sex, skeletal maturation, and age. Children's nasal skeletal tissues predicted nasal soft tissue reasonably well.

Adjuvant Therapy for Revision Rhinoplasty of Contracted Nose Using Polydeoxyribonucleotide and Invasive Bipolar Radiofrequency.

Most cases of severely contracted nose require revision rhinoplasty and septoplasty, wherein preoperative and/or intraoperative expansion of nasal soft tissue is necessary for tension-free revision surgery. The present study aimed to evaluate the efficacy and safety of pre- and postoperative adjuvant therapy using polydeoxyribonucleotide (PDRN) and invasive, pulsed-type, bipolar, alternating current radiofrequency (RF) for revision surgery of a contracted nose. In total, 30 patients were treated with 16 sessions (8 preoperative sessions and 8 postoperative sessions) of intralesional injection of PDRN and invasive RF treatment using microneedle electrodes at 1-week intervals. One week after the final combined pretreatment using PDRN and invasive bipolar RF, the skin of contracted noses was sufficiently softened, and nasal skin mobility was notably improved in all the patients. During revision rhinoplasty and septoplasty, the contracted nasal skin in each patient was adequately released for proper covering of the nasal tip without tension. Postoperatively, 8 sessions of adjuvant therapy elicited marked clinical improvements in persistent nasal tip dimpling and contracture, septal deviation, and warping from the incomplete recovery of nasal contracture after revision surgery. In conclusion, our pre- and postoperative adjuvant therapies using PDRN and invasive bipolar RF remarkably improved the therapeutic outcomes of revision rhinoplasty and septoplasty for contracted skin of the nose without major side effects.

Nasal Soft Tissue Change Following Bimaxillary Orthognathic Surgery.

The purpose of this study is to identify the correlation between maxillary movement and nasal soft tissue changes on three-dimensional reconstructed cone beam computed tomography (CBCT) images after Le Fort I osteotomy. The authors also investigate the long-term change of alar base width (ABW) to determine the effect of cinch suture. The authors retrospectively studied 52 subjects (14 males and 38 females) who were treated by bimaxillary orthognathic surgery including Le Fort I osteotomy and mandibular ramus surgery. The landmarks and planes were established on three-dimensional reconstructed CBCT images. The authors measured each parameters preoperatively, 1 month postoperatively, and 1 year postoperatively. There was no significant correlation between the horizontal movement of A-point and the widening of ABW (P < 0.038), nor was there a significant correlation between the vertical movement of A-point and the change of ABW (P < 0.61). There was no significant correlation between horizontal and vertical movement of anterior nasal spine and the widening of ABW, nor was there a significant correlation between the nasal tip length and the vector of maxillary movement. There was no significant correlation between the ABW widening and the vector of surgical maxillary movement. The effect and stability of the alar base cinch suture is difficult to determine and require further investigation.

Repair of Nasal Soft Tissue Defects with Paramedian Forehead Skin Flap with Base at the Supraorbital Artery Region

Purpose: This study is used to explore the method for repairing nasal soft tissue defects with paramedian forehead skin flap with base at the supraorbital artery region and its curative effect. Method: Retrospective case study. Clinical data of one case of a patient with defects of most nasal soft tissue in China–Japan Union Hospital of Jilin University were used. The forehead flap with base at the supraobital artery will be transferred to nasal soft tissue defects so as to repair the nose of the patient. Result: All forehead flaps with the blood supplied by supraobital artery of one patient case all survived. The blood supply of the flap is stable because quality, color and luster are all similar with those of the nose. No bleeding, flap hypertrophy or overstaffed pedicle appeared after the operation. They all healed up in Phase I. Conclusion: Paramedian forehead skin flap with base at the supraorbital artery region is an ideal flap supply for repairing most nasal soft tissue defects.