Rhinoplasty: Considerations for Patients with Facial Paralysis

Aishwarya Shukla; G. Nina Lu

doi:10.1055/a-2127-3768

Facial Plastic Surgery, Inhaltsverzeichnis

Facial Plast Surg 2023; 39(06): 638-641
DOI: 10.1055/a-2127-3768

Original Article

Rhinoplasty: Considerations for Patients with Facial Paralysis

Aishwarya Shukla

¹Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington

,

G. Nina Lu

¹Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington

› Institutsangaben

Abstract

Nasal obstruction is a common sequela of flaccid facial paralysis but one that is often underaddressed surgically. Weakness of nasal musculature on the paralyzed side of the face leads to nasal valve narrowing through loss of static and dynamic nasal side wall tone as well as inferomedial displacement of the alar base. Standard rhinoplasty techniques such as alar batten grafts or flaring sutures may be used to support the nasal side wall in facial paralysis. However, to address the inferomedial alar displacement, suspension techniques are often required. Suture resuspension and fascia lata resuspension techniques are described, with modifications to each to improve longevity of the suspension.

Keywords

facial paralysis - nasal suspension - fascia lata suspension - nasal - obstruction

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Referenzen

References
1 May M, West JW, Hinderer KH. Nasal obstruction from facial palsy. Arch Otolaryngol 1977; 103 (07) 389-391
2 Lindsay RW, Smitson C, Edwards C, Cheney ML, Hadlock TA. Correction of the nasal base in the flaccidly paralyzed face: an orphaned problem in facial paralysis. Plast Reconstr Surg 2010; 126 (04) 185e-186e
3 Bruintjes TD, van Olphen AF, Hillen B, Huizing EH. A functional anatomic study of the relationship of the nasal cartilages and muscles to the nasal valve area. Laryngoscope 1998; 108 (07) 1025-1032
4 GRIESMAN B. Muscles and cartilages of the nose from the standpoint of a typical rhinoplasty. Arch Otolaryngol 1944; 39 (04) 334-341
5 Letourneau A, Daniel RK. The superficial musculoaponeurotic system of the nose. Plast Reconstr Surg 1988; 82 (01) 48-57
6 Hoeyberghs JL, Desta K, Matthews RN. The lost muscles of the nose. Aesthetic Plast Surg 1996; 20 (02) 165-169
7 Bruintjes TD, Olphen AF, Hillen B, Weijs WA. Electromyography of the human nasal muscles. Eur Arch Otorhinolaryngol 1996; 253 (08) 464-469
8 Strohl KP, O'Cain CF, Slutsky AS. Alae nasi activation and nasal resistance in healthy subjects. J Appl Physiol 1982; 52 (06) 1432-1437
9 Cole P. Biophysics of nasal airflow: a review. Am J Rhinol 2000; 14 (04) 245-249
10 Connel DC, Fregosi RF. Influence of nasal airflow and resistance on nasal dilator muscle activities during exercise. J Appl Physiol 1993; 74 (05) 2529-2536
11 Kienstra MA, Gassner HG, Sherris DA, Kern EB. Effects of the nasal muscles on the nasal airway. Am J Rhinol 2005; 19 (04) 375-381
12 Pou JD, Patel KG, Oyer SL. Treating nasal valve collapse in facial paralysis: what I do differently. Facial Plast Surg Clin North Am 2021; 29 (03) 439-445
13 Paniello RC. Nasal valve suspension. An effective treatment for nasal valve collapse. Arch Otolaryngol Head Neck Surg 1996; 122 (12) 1342-1346
14 Friedman M, Ibrahim H, Lee G, Joseph NJ. A simplified technique for airway correction at the nasal valve area. Otolaryngol Head Neck Surg 2004; 131 (04) 519-524
15 Soler ZM, Rosenthal E, Wax MK. Immediate nasal valve reconstruction after facial nerve resection. Arch Facial Plast Surg 2008; 10 (05) 312-315
16 Nuara MJ, Mobley SR. Nasal valve suspension revisited. Laryngoscope 2007; 117 (12) 2100-2106
17 Rose EH. Autogenous fascia lata grafts: clinical applications in reanimation of the totally or partially paralyzed face. Plast Reconstr Surg 2005; 116 (01) 20-32 , discussion 33–35
18 Lindsay RW, Bhama P, Hohman M, Hadlock TA. Prospective evaluation of quality-of-life improvement after correction of the alar base in the flaccidly paralyzed face. JAMA Facial Plast Surg 2015; 17 (02) 108-112
19 Ziegler JP, Marston AP, Oyer SL. Fascia lata suspension of the nasal valve in facial paralysis: an endonasal approach. Facial Plast Surg Aesthet Med 2020; 22 (06) 481-482
20 Oyer SL. Static lower facial reconstruction in facial paralysis. Oper Tech Otolaryngol–Head Neck Surg 2021; 32 (04) 219-225
21 Lafer MP. O TM. Management of long-standing flaccid facial palsy: static approaches to the brow, midface, and lower lip. Otolaryngol Clin North Am 2018; 51 (06) 1141-1150