Download PDF
Laryngorhinootologie 2007; 86: 15-39
DOI: 10.1055/s-2007-966291
Funktionelle und ästhetische Chirurgie der Nase

© Georg Thieme Verlag KG Stuttgart · New York

Indikationen und Techniken der Rhinoplastik

A.-J.  Tasman1
  • 1HNO-Klinik, Hals- und Gesichtschirurgie (Direktor: Prof. Dr. R. Grossenbacher), Kantonsspital St. Gallen
Further Information

Publication History

Publication Date:
13 April 2007 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Die Rhinoplastik gilt als eine der technisch anspruchsvollsten Operationen der Kopf-Halschirurgie, und reproduzierbar gute Ergebnisse setzen eine sorgfältige Indikation, eine sichere Operationstechnik und viel Erfahrung voraus. Kontroversen zu Indikation und Technik halten auch mehr als ein Jahrhundert nach der ersten Rhinoplastik an. Diese Arbeit bietet einen Überblick über den aktuellen Stand dieser Diskussion. Dabei werden psychologische Aspekte, die Vorbereitung des Eingriffs ebenso wie operationstechnische Details sowie Lösungsvorschläge für typische Befundkonstellationen dargestellt.

Schlüsselwörter

Rhinoplastik - Psychologie - Operationstechnik - Operationsindikation - Osteotomie - Flügelknorpelplastik - Augmentationsplastik - Patientenselektion

Literatur

  • 1 Tardy Jr M E. Rhinoplasty: The art and the science. Philadelphia, Pennsylvania; W. B. Saunders Company 1997
    Google Scholar
  • 2 Gunter J P, Rohrich R J, Adams W P. (eds) .Dallas rhinoplasty: nasal surgery by the masters. St. Louis; Quality Medical Publishing 2002
    Google Scholar
  • 3 Sheen J H. Rhinoplasty: personal evolution and milestones.  Plast Reconstr Surg. 2000;  105 1820-1852
    CrossrefPubMedGoogle Scholar
  • 4 Stucker F J. Rhinoplasty from the Goldman/Cottle schools to the present: a survey of 7447 personal cases.  Am J Rhinol. 2003;  17 23-26
    PubMedGoogle Scholar
  • 5 Millard D R. A rhinoplasty tetralogy: corrective, secondary, congenital, reconstructive. Boston; Little, Brown and Company (Inc.) 1996
    Google Scholar
  • 6 Roe J O. The Deformity Termed „Pug Nose” and its correction with a simple operation (Reprinted from The Medical Record, June 4, 1887).  Plast Reconstr Surg. 1970;  45 78-83
    CrossrefPubMedGoogle Scholar
  • 7 Hauben D J. Die Geschichte der Rhinoplastik.  Laryngo Rhinol Otol. 1983;  62 53-54
    PubMedGoogle Scholar
  • 8 Rubin F F. Reconstruction of the bony nasal pyramid. Three new instruments.  Arch Otolaryngol. 1968;  88 279-282
    PubMedGoogle Scholar
  • 9 Safian J. Instruments for rhinoplasty.  Plast Reconstr Surg. 1970;  45 288-289
    PubMedGoogle Scholar
  • 10 Wilkie T F. A nasal saw of modified design.  Br J Plast Surg. 1967;  20 220-221
    CrossrefPubMedGoogle Scholar
  • 11 Peet E. An improved rasp for corrective rhinoplasty.  Br J Plast Surg. 1968;  21 215
    CrossrefPubMedGoogle Scholar
  • 12 McGregor I A. A nasal osteotome.  Br J Plast Surg. 1967;  20 222
    PubMedGoogle Scholar
  • 13 Drever J M. A guided osteotome for the resection of the osteocartilaginous nasal hump.  Plast Reconstr Surg. 1978;  62 611-612
    PubMedGoogle Scholar
  • 14 Georgi W. The double chisel - a new nasal osteotome.  HNO. 1977;  25 401-403
    PubMedGoogle Scholar
  • 15 Goodman W S. The rotating burr in rhinoplasty.  Arch Otolaryngol. 1981;  107 436-438
    PubMedGoogle Scholar
  • 16 Becker D G. The powered rasp: advanced instrumentation for rhinoplasty.  Arch Facial Plast Surg. 2002;  4 267-268
    CrossrefPubMedGoogle Scholar
  • 17 Becker D G, Park S S, Toriumi D M. Powered instrumentation for rhinoplasty and septoplasty.  Otolaryngol Clin North Am. 1999;  32 683-693
    CrossrefPubMedGoogle Scholar
  • 18 Berghaus A. New instruments for rhinoplasty: operating mirror and alar guiding set.  Plast Reconstr Surg. 2006;  117 2224-2225
    CrossrefPubMedGoogle Scholar
  • 19 American Academy of Facial Plastic and Reconstructive Surgery 2004 Membership Survey .Trends in Facial Plastic Surgery 2005.  http://www.AAFPRS.org, 10. 8. 2006
    Google Scholar
  • 20 Hay G G, Heather B B. Changes in psychometric test results following cosmetic nasal operations.  Br J Psychiatry. 1973;  122 89-90
    CrossrefPubMedGoogle Scholar
  • 21 Ercolani M, Baldaro B, Rossi N, Trombini G. Five-year follow-up of cosmetic rhinoplasty.  J Psychosom Res. 1999;  47 283-286
    CrossrefPubMedGoogle Scholar
  • 22 Dinis P B, Dinis M, Gomes A. Psychological consequences of nasal aesthetic and functional surgery: a controlled prospective study in an ENT setting.  Rhinology. 1998;  36 32-36
    PubMedGoogle Scholar
  • 23 Sarwer D B, Pertschuk M J, Wadden T A, Whitaker L A. Psychological investigations in cosmetic surgery: a look back and a look ahead.  Plast Reconstr Surg. 1998;  101 1136-1142
    CrossrefPubMedGoogle Scholar
  • 24 Rankin M, Borah G L, Perry A W, Wey P D. Quality-of-life outcomes after cosmetic surgery.  Plast Reconstr Surg. 1998;  102 2139-2145
    CrossrefPubMedGoogle Scholar
  • 25 Haraldsson P. Psychological impact of cosmetic rhinoplasty.  Aesthetic Plast Surg. 1999;  23 170-175
    CrossrefPubMedGoogle Scholar
  • 26 Shulman J, Westreich M. Rhinoplasty update: preoperative evaluation of 4040 cases.  Aesthetic Plast Surg. 1983;  7 227-232
    CrossrefPubMedGoogle Scholar
  • 27 Shulman O, Westreich M, Shulman J. Motivation for rhinoplasty: changes in 5970 cases, in three groups, 1964 to 1997.  Aesthetic Plast Surg. 1998;  22 420-424
    CrossrefPubMedGoogle Scholar
  • 28 Napoleon A, Lewis C M. Psychological considerations in lipoplasty: The problematic or „special care” patient.  Ann Plast Surg. 1989;  23 430-432
    CrossrefPubMedGoogle Scholar
  • 29 Edgerton M T, Langmen M W. Psychiatric considerations. In: Courtiss EH (ed) Male aesthetic surgery. St Louis; Mosby 1982
    Google Scholar
  • 30 Goin J M, Goin M K. Psychological understanding and management of the plastic surgery patient. In: Georgiade NG, Georgiade GS, Riefkohl R, Barwick WJ (eds) Essentials of Plastic, Maxillofacial and reconstructive surgery. Baltimore; Williams and Wilkins 1987
    Google Scholar
  • 31 Marcus P. Psychological aspects of cosmetic rhinoplasty.  Br J Plast Surg. 1984;  37 313-318
    CrossrefPubMedGoogle Scholar
  • 32 Robin A A, Copas J B, Jack A B, Kaerser A C, Thomas P J. Reshaping the psyche: The concurrent improvement in appearance and mental state after rhinoplasty.  Br J Psychiatry. 1988;  152 539-543
    CrossrefPubMedGoogle Scholar
  • 33 Sheard C, Jones N S, Quraishi M S, Herbert M. A prospective study of the psychological effects of rhinoplasty.  Clin Otolaryngol. 1996;  21 232-236
    CrossrefPubMedGoogle Scholar
  • 34 Klassen A, Jenkinson C, Fitzpatrick R, Goodacre T. Patients’ health related quality of life before and after aesthetic surgery.  Br J Plast Surg. 1996;  49 433-438
    CrossrefPubMedGoogle Scholar
  • 35 Cole R P, Shakespeare V, Shakespeare P, Hobby J A. Measuring outcome in low-priority plastic surgery patients using Quality of Life indices.  Br J Plast Surg. 1994;  47 117-121
    CrossrefPubMedGoogle Scholar
  • 36 Pruzinski T, Edgerton M T. Body image change in cosmetic plastic surgery. In: Cash TF, Pruzinsky T (eds) Body images: development, deviance and change. New York; Guilford 1990
    Google Scholar
  • 37 McKiernan D C, Banfield G, Kumar R, Hinton A E. Patient benefit from functional and cosmetic rhinoplasty.  Clin Otolaryngol. 2001;  26 50-52
    CrossrefPubMedGoogle Scholar
  • 38 Hill G, Silver A G. Psychodynamic and motivations for plastic surgery.  Psychol Med. 1950;  12 345-355
    PubMedGoogle Scholar
  • 39 Linn L, Goldman I B. Psychiatric observations concerning rhinoplasty.  Psychol Med. 1949;  11 307
    PubMedGoogle Scholar
  • 40 Meyer E, Jacobson W E, Edgerton M T, Canter A. Motivational patterns in patients seeking elective plastic surgery.  Psychol Med. 1960;  22 193
    PubMedGoogle Scholar
  • 41 Hay G G. Psychiatric aspects of cosmetic nasal operations.  Br J Psychiatry. 1970;  116 85
    CrossrefPubMedGoogle Scholar
  • 42 Wright M R, Wright W K. A psychological study of patients undergoing cosmetic surgery.  Arch Otolaryngol. 1975;  101 145
    CrossrefPubMedGoogle Scholar
  • 43 Goin M K, Rees T D. A prospective study of patients’ psychological reactions to rhinoplasty.  Ann Plast Surg. 1991;  27 210
    CrossrefPubMedGoogle Scholar
  • 44 Meerloo J. The fate of one’ s face.  Psychiatric quarterly. 1956;  30 31
    PubMedGoogle Scholar
  • 45 Roubichek J. Zur Psychopathologie des kosmetischen Fehlers.  Aesthet Med. 1960;  9 21
    PubMedGoogle Scholar
  • 46 Edgerton M T, Jacobson W E, Meyer E. Surgical-psychiatric study of patients seeking plastic (cosmetic) surgery.  Br J Plast Surg. 1960;  13 136
    CrossrefPubMedGoogle Scholar
  • 47 Edgerton M T, Langman M W, Pruzinsky T. Plastic surgery and psychotherapy in the treatment of 100 psychologically disturbed patients.  Plast Reconstr Surg. 1991;  88 594-608
    CrossrefPubMedGoogle Scholar
  • 48 Crerand C E, Phillips K A, Menard W, Fay C. Nonpsychiatric Medical Treatment of Body Dysmorphic Disorder.  Psychosomatics. 2005;  46 549-555
    CrossrefPubMedGoogle Scholar
  • 49 Behrbohm H, Tardy Jr M E. Funktionell-ästhetische Chirurgie der Nase. Septorhinoplastik. Stuttgart, New York; Thieme 2004
    Google Scholar
  • 50 Slator R, Harris D L. Are rhinoplasty patients potentially mad?.  Br J Plast Surg. 1992;  45 301
    PubMedGoogle Scholar
  • 51 Macgregor F C. Social, psychological and cultural dimensions of cosmetic and reconstructive plastic surgery.  Aesthetic Plast Surg. 1989;  13 1
    CrossrefPubMedGoogle Scholar
  • 52 Gorney M, Martello J. Patient selection criteria. Medical-legal issues in plastic surgery.  Clin plast surg. 1999;  26 37
    PubMedGoogle Scholar
  • 53 Rohrich R I. Streamlining cosmetic surgery patient selection - just say no.  Plast Reconstr Surg. 1999;  104 220
    CrossrefPubMedGoogle Scholar
  • 54 Sheen J H, Sheen A P. (eds) .Aesthetic Rhinoplasty, 2nd ed. St. Louis; Quality Medical Publishing 1998 (reprint of 1987 ed.)
    Google Scholar
  • 55 Powell N, Humphreys B. Proportions of the aesthetic face. New York, NY; Thieme Stratton Inc 1984
    Google Scholar
  • 56 Becker O J. Rhinoplasty: Cultural, esthetic and psychological aspects.  Chicago Med. 1961;  64 15
    PubMedGoogle Scholar
  • 57 Berghaus A. Die Chirurgie der Nasenspitze.  Laryngo Rhino Otol. 1997;  76 680-681
    PubMedGoogle Scholar
  • 58 Nolst Trenité G J. Rhinoplasty; A practical guide to functional and aesthetic surgery of the nose. The Hague, Netherlands; Kugler Publications 2005
    Google Scholar
  • 59 Tasman A J, Helbig M. Sonography of nasal tip anatomy and surgical tip refinement.  Plast Reconstr Surg. 2000;  105 2573-2579
    CrossrefPubMedGoogle Scholar
  • 60 Briner H R, Simmen D, Jones N. Impaired sense of smell in patients with nasal surgery.  Clin Otolaryngol Allied Sci. 2003;  28 417-419
    CrossrefPubMedGoogle Scholar
  • 61 Kobal G, Hummel T, Sekinger B, Barz S, Roscher S, Wolf S. „Sniffin’ sticks”: screening of olfactory performance.  Rhinology. 1996;  34 222-226
    PubMedGoogle Scholar
  • 62 Simmen D, Briner H R, Hess K. Screeningtest des Geruchsinnes mit Riechdisketten.  Laryngo Rhino Otol. 1999;  78 125-130
    PubMedGoogle Scholar
  • 63 Galdino G M, Da Silva A D, Gunter J P. Digital photography for rhinoplasty.  Plast Reconstr Surg. 2002;  109 1421-1434
    PubMedGoogle Scholar
  • 64 Hirche W. Arztrecht kompakt. Juristischer Ratgeber für die Arztpraxis. München; MD-Verlag 1994
    Google Scholar
  • 65 Gruber R P. Computer imaging and surgical reality in aesthetic rhinoplasty.  Plast Reconstr Surg. 2005;  116 922-923
    CrossrefPubMedGoogle Scholar
  • 66 Mühlbauer W, Holm C. Computer imaging and surgical reality in aesthetic rhinoplasty.  Plast Reconstr Surg. 2005;  115 2098-2104
    CrossrefPubMedGoogle Scholar
  • 67 Moses S, Mahler D. After aesthetic rhinoplasty: new looks and psychological outlooks on post-surgical satisfaction.  Aesthetic Plast Surg. 1984;  8 213
    CrossrefPubMedGoogle Scholar
  • 68 Goin M K, Rees T D. A prospective study of patients’ psychological reactions to rhinoplasty.  Ann Plast Surg. 1991;  27 210-215
    CrossrefPubMedGoogle Scholar
  • 69 Perkins S W, Hamilton M M. Endonasale Zugänge zur Nasenspitze. In: Behrbohm H, Tardy ME Jr (eds) Funktionell-ästhetische Chirurgie der Nase. Stuttgart, New York; Thieme 2004
    Google Scholar
  • 70 Demirtas Y, Ayhan S, Tulmac M, Findikcioglu F, Ozkose Z, Yalcin R, Atabay K. Hemodynamic effects of perioperative stressor events during rhinoplasty.  Plast Reconstr Surg. 2005;  115 620-626
    CrossrefPubMedGoogle Scholar
  • 71 Cavallini M, Baruffaldi Preis F W, Casati A. Effects of mild hypothermia on blood coagulation in patients undergoing elective plastic surgery.  Plast Reconstr Surg. 2005;  116 316-321
    CrossrefPubMedGoogle Scholar
  • 72 Kim D W, Toriumi D M. Rhinoplastik in offener Technik. In: Behrbohm H, Tardy ME Jr (eds) Funktionell-ästhetische Chirurgie der Nase. Septorhinoplastik. Stuttgart, New York; Thieme 2004
    Google Scholar
  • 73 Huizing E H, de Groot J AM. (eds) .Functional reconstructive Nasal surgery. Stuttgart, New York; Thieme 2003
    Google Scholar
  • 74 Rajan G P, Fergie N, Fischer U, Romer M, Radivojevic V, Hee G K. Antibiotic prophylaxis in septorhinoplasty? A prospective, randomized study.  Plast Reconstr Surg. 2005;  116 1995-1998
    CrossrefPubMedGoogle Scholar
  • 75 Michelson A, Wolf S R, Rettinger G, Zichner M. Antibiotikaprophylaxe in der Rhinochirurgie.  HNO. 1993;  41 421-425
    PubMedGoogle Scholar
  • 76 Tasman A J, Wallner F, Neumeier R. Antibiotische Imprägnation von Knorpelimplantaten: Diffusionskinetik von Fluorchinolonen.  Laryngorhinootologie. 2000;  79 30-33
    Article in Thieme ConnectPubMedGoogle Scholar
  • 77 Kittel H, Masing H. Corticosteroid therapy in rhinoplasty.  Rhinology.. 1976;  14 163-166
    PubMedGoogle Scholar
  • 78 Kara C O, Gokalan I. Effects of single-dose steroid usage on edema, ecchymosis, and intraoperative bleeding in rhinoplasty.  Plast Reconstr Surg. 1999;  104 2213-2218
    PubMedGoogle Scholar
  • 79 Hanasono M M, Kridel R W, Pastorek N J, Glasgold M J, Koch R J. Correction of the soft tissue pollybeak using triamcinolone injection.  Arch Facial Plast Surg. 2002;  4 26-30
    CrossrefPubMedGoogle Scholar
  • 80 Sclafani A P, Romo 3rd  T, Barnett J G, Barnett C R. Adjustment of subtle postoperative nasal defects: managing the „near-miss” rhinoplasty.  Facial Plast Surg. 2003;  19 349-361
    Article in Thieme ConnectPubMedGoogle Scholar
  • 81 Guyuron B. Discussion: Changing the Convexity and Concavity of Nasal Cartilages and Cartilage Grafts with Horizontal Mattress Sutures; Part I. Experimental Results and Part II. Clinical Results.  Plast Reconstr Surg. 2005;  115 607-608
    CrossrefPubMedGoogle Scholar
  • 82 Sheen J H. The ideal dorsal graft: A continuing quest.  Plast Reconstr Surg. 1998;  102 2490
    CrossrefPubMedGoogle Scholar
  • 83 Rettinger G. Eingriffe der Nase. In: Theissing J, Rettinger G, Werner J (Hrsg.) HNO-Operationslehre, 4. Aufl. Stuttgart, New York; Thieme 2005
    Google Scholar
  • 84 Gibson T, Davis W B. Distortion of autogenous rib grafts: its cause and prevention.  Br J Plast Surg. 1957;  10 247-274
    PubMedGoogle Scholar
  • 85 Agaoglu G, Erol O O. In situ split costal cartilage graft harvesting through a small incision using a gouge.  Plast Reconstr Surg. 2000;  106 932-935
    Google Scholar
  • 86 Jackson I T, Yavuzer R. Alloderm for Dorsal Nasal Irregularities.  Plast Reconstr Surg. 2001;  107 551-558
    CrossrefPubMedGoogle Scholar
  • 87 Daniel R K, Calvert J W. Diced cartilage grafts in rhinoplasty surgery.  Plast Reconstr Surg. 2004;  113 2156-2171
    CrossrefPubMedGoogle Scholar
  • 88 Calvert J W, Brenner K, DaCosta-Iyer M, Evans G R, Daniel R K. Histological analysis of human diced cartilage grafts.  Plast Reconstr Surg. 2006;  118 230-236
    CrossrefPubMedGoogle Scholar
  • 89 Erol O O. The Turkish delight: a pliable graft for rhinoplasty.  Plast Reconstr Surg. 2000;  105 2229-2241
    CrossrefPubMedGoogle Scholar
  • 90 Elahi M M, Jackson I T, Moreira-Gonzalez A, Yamini D. Nasal augmentation with Surgicel-wrapped diced cartilage: a review of 67 consecutive cases.  Plast Reconstr Surg. 2003;  111 1309-1318
    CrossrefPubMedGoogle Scholar
  • 91 Gurley J M, Pilgram T, Perlyn C A, Marsh J L. Long-term outcome of autogenous rib graft nasal reconstruction.  Plast Reconstr Surg. 2001;  108 1895-1905
    CrossrefPubMedGoogle Scholar
  • 92 Reich J. The application of dermis grafts in deformities of the nose.  Plast Reconstr Surg. 1983;  71 772
    CrossrefPubMedGoogle Scholar
  • 93 Erdogan B, Tuncel A, Adanali G, Deren O, Ayhan M. Augmentation rhinoplasty with dermal graft and review of the literature.  Plast Reconstr Surg. 2003;  111 2060-2068
    CrossrefPubMedGoogle Scholar
  • 94 Gryskiewicz J M. Waste not, want not: the use of AlloDerm in secondary rhinoplasty.  Plast Reconstr Surg. 2005;  116 1999-2004
    CrossrefPubMedGoogle Scholar
  • 95 Gryskiewicz J M, Rohrich R J, Reagan B J. The use of alloderm for the correction of nasal contour deformities.  Plast Reconstr Surg. 2001;  107 561-570
    PubMedGoogle Scholar
  • 96 Miller T A. Temporalis fascia grafts for facial and nasal contour augmentation.  Plast Reconstr Surg. 1988;  81 524
    CrossrefPubMedGoogle Scholar
  • 97 Baker T M, Courtiss E H. Temporalis fascia grafts in open secondary rhinoplasty.  Plast Reconstr Surg. 1994;  93 802
    CrossrefPubMedGoogle Scholar
  • 98 Guerrerosantos J. Temporoparietal free fascia grafts in rhinoplasty.  Plast Reconstr Surg. 1984;  74 465
    CrossrefPubMedGoogle Scholar
  • 99 Sheen J H. Temporoparietal free fascia grafts in rhinoplasty (Discussion).  Plast Reconstr Surg. 1984;  74 475
    PubMedGoogle Scholar
  • 100 Leaf N. SMAS autografts for the nasal dorsum.  Plast Reconstr Surg. 1996;  97 1249
    CrossrefPubMedGoogle Scholar
  • 101 Koronas T C, Bucky L P, Hurley C, May J W. The fate of suctioned and surgically removed fat after reimplantation for soft-tissue augmentation: A volumetric and histologic study in the rabbit.  Plast Reconstr Surg. 1993;  91 763-770
    PubMedGoogle Scholar
  • 102 Romo 3rd  T, Sclafani A P, Jacono A A. Nasal reconstruction using porous polyethylene implants.  Facial Plast Surg. 2000;  16 55-61
    PubMedGoogle Scholar
  • 103 McCurdy Jr J A. The Asian nose: augmentation rhinoplasty with L-shaped silicone implants.  Facial Plast Surg. 2002;  18 245-52
    Article in Thieme ConnectPubMedGoogle Scholar
  • 104 Mackay I S. Augmentation rhinoplasty. In: Nolst Trenité GJ Rhinoplasty; A practical guide to functional and aesthetic surgery of the nose. The Hague, Netherlands; Kugler Publications 2005
    Google Scholar
  • 105 Lawson W, Reino A J, Seidman D. The silicone columellar strut.  Plast Reconstr Surg. 1996;  97 938-943
    PubMedGoogle Scholar
  • 106 Beekhuis G J. Silastic alar-columellar prosthesis in conjunction with rhinoplasty.  Arch Otolaryngol. 1982;  108 429-432
    PubMedGoogle Scholar
  • 107 Baran C N, Tiftikcioglu Y O, Baran N K. The use of alloplastic materials in secondary rhinoplasties: 32 years of clinical experience.  Plast Reconstr Surg. 2005;  116 1502-1516
    CrossrefPubMedGoogle Scholar
  • 108 Stoll W. The use of polytetrafluoroethylene for particular augmentation of the nasal dorsum.  Aesthetic Plast Surg. 1991;  15 233
    CrossrefPubMedGoogle Scholar
  • 109 Waldman S R. Gore-Tex for augmentation of the nasal dorsum: a preliminary report.  Ann Plast Surg. 1991;  26 520-525
    CrossrefPubMedGoogle Scholar
  • 110 Zhanqiang L. Carving Gore-Tex reinforced sheets for augmentation rhinoplasty in Chinese patients.  Plast Reconstr Surg. 2006;  117 326-328
    CrossrefPubMedGoogle Scholar
  • 111 Stal S, Hollier L. The use of resorbable spacers for nasal spreader grafts.  Plast Reconstr Surg. 2000;  106 922-928
    CrossrefPubMedGoogle Scholar
  • 112 Gilmore J. Use of Vicryl mesh in prevention of postrhinoplasty dorsal irregularities.  Ann Plast Surg. 1989;  22 105
    CrossrefPubMedGoogle Scholar
  • 113 Kamer F M, Parkes M L. Gelatin film: A useful adjunct in rhinoplastic surgery.  Acta Otolaryngol. 1977;  103 667
    PubMedGoogle Scholar
  • 114 Carey J W, Steegmann Jr A T. Human nasal protrusion, latitude, and climate.  Am J Phys Anthropol. 1981;  56 313-319
    CrossrefPubMedGoogle Scholar
  • 115 Franciscus R G, Trinkaus E. Nasal morphology and the emergence of Homo erectus.  Am J Phys Anthropol. 1988;  75 517-527
    CrossrefPubMedGoogle Scholar
  • 116 Rubin F F. Two New Instruments for Rhinoplastic Surgery.  Arch Otolaryng. 1967;  85 698-700
    PubMedGoogle Scholar
  • 117 Rohrich R J, Muzaffar A R, Janis J E. Component dorsal hump reduction: the importance of maintaining dorsal aesthetic lines in rhinoplasty.  Plast Reconstr Surg. 2004;  114 1298-1308
    PubMedGoogle Scholar
  • 118 Camirand A, Doucet J, Harris J. Nose surgery: how to prevent a middle vault collapse - a review of 50 patients 3 to 21 years after surgery.  Plast Reconstr Surg. 2004;  114 527-534
    CrossrefPubMedGoogle Scholar
  • 119 Guyuron B. Precision rhinoplasty. Part II: prediction.  plast Reconstr Surg. 1988;  81 500
    CrossrefPubMedGoogle Scholar
  • 120 Huizing E H, de Groot J AM. Functional reconstructive Nasal surgery. Stuttgart, New York; Thieme 2003
    Google Scholar
  • 121 Peck G C. Rhinoplasty. Stuttgart; Georg Thieme Verlag 1984
    Google Scholar
  • 122 Trepsat F. A different rasp for rhinoplasty.  Plast Reconstr Surg. 1987;  79 638-639
    PubMedGoogle Scholar
  • 123 Mang W L. Manual of aesthetic surgery. Berlin, Heidelberg, New York; Springer-Verlag 2002
    Google Scholar
  • 124 Wright W K. Study on hump removal in rhinoplasty.  Laryngoscope. 1967;  77 508
    CrossrefPubMedGoogle Scholar
  • 125 Skoog T. A method of hump reduction in rhinoplasty.  Arch Otolaryngol. 1966;  83 283-287
    CrossrefPubMedGoogle Scholar
  • 126 Harshbarger R J, Sullivan P K. The optimal medial osteotomy: a study of nasal bone thickness and fracture patterns.  Plast Reconstr Surg. 2001;  108 2114-2119
    CrossrefPubMedGoogle Scholar
  • 127 Bhatia K, Jones N S, Bull T R. The use of Heanley bone-cutting forceps to reduce the thickened and broad bony dorsum in rhinoplasty.  Arch Facial Plast Surg. 2002;  4 186-189
    CrossrefPubMedGoogle Scholar
  • 128 Aiach G. Atlas of Rhinoplasty: Open and endonasal approaches. St. Louis, Missouri; Quality Medical Publishing 1996
    Google Scholar
  • 129 Byrd H S, Salomon J, Wood J. Correction of the crooked nose.  Plast Reconstr Surg. 1998;  102 2148-2150
    CrossrefPubMedGoogle Scholar
  • 130 Meyer R. Crooked nose. In: Gruber RP, Peck GC (eds) Rhinoplasty: State of the Art. St. Louis; Mosby 1993
    Google Scholar
  • 131 Denecke H, Meyer R. Plastic Surgery of Head and Neck: Corrective and Reconstructive Rhinoplasty. New York, NY; Springer-Verlag NY Inc 1967
    Google Scholar
  • 132 Giampapa V C, DiBernardo B E. Nasal osteotomy - utilizing dual plane reciprocating nasal saw blades: a 6-year follow-up.  Ann Plast Surg. 1993;  30 500-502
    PubMedGoogle Scholar
  • 133 Castro A, Jackson I T, Rademaker B. Rhinoplasty saw: a modified design.  Ann Plast Surg. 1991;  26 600-601
    CrossrefPubMedGoogle Scholar
  • 134 Diamond H P. Rhinoplasty technique.  Surg Clin North Am. 1971;  51 317-331
    PubMedGoogle Scholar
  • 135 Rees T D. Nasal osteotomies: A clinical comparison of the perforating methods versus the continuous technique. Letters and viewpoints.  Plast Reconstr Surg. 2005;  115 1783-1784
    PubMedGoogle Scholar
  • 136 Rohrich R J, Krueger J K. The lateral osteotomy in rhinoplasty: Clinical and radiographic rationale for osteotome selection (Discussion).  Plast Reconst Surg. 1999;  105 1817-1819
    PubMedGoogle Scholar
  • 137 Rohrich R J, Minoli J J, Adams W P, Hollier L H. The lateral nasal osteotomy in rhinoplasty: An anatomic endoscopic comparison of the external versus the internal approach.  Plast Reconstr Surg. 1997;  99 1309
    CrossrefPubMedGoogle Scholar
  • 138 Hilger J A. The internal lateral osteotomy in rhinoplasty.  Arch Otolaryngol. 1968;  88 119
    PubMedGoogle Scholar
  • 139 Parkes M L, Kayner F, Morgan W R. Double lateral osteotomy in rhinoplasty.  Arch Otolaryngol. 1977;  103 344-348
    CrossrefPubMedGoogle Scholar
  • 140 Goldfarb M, Gallups J M, Gensin J M. Perforating osteotomies in rhinoplasty.  Arch Otolaryngol Head Neck Surg. 1993;  119 624
    CrossrefPubMedGoogle Scholar
  • 141 Tardy M E, Denneny J C. Micro-osteotomies in rhinoplasty.  Facial Plast Surg. 1984;  1 137
    Article in Thieme ConnectPubMedGoogle Scholar
  • 142 Larrabee W. Open rhinoplasty and the upper third of the nose.  Facial Plast Surg Clin North Am. 1993;  1 23
    PubMedGoogle Scholar
  • 143 Murakami C S, Younger R AL. Managing the postrhinoplasty or post-traumatic crooked nose.  Facial plast Surg Clin North Am. 1995;  3 421
    PubMedGoogle Scholar
  • 144 Webster R C, Davidson T M, Smith R C. Curved lateral osteotomy for airway protection in rhinoplasty.  Arch Otolaryngol. 1977;  103 454
    CrossrefPubMedGoogle Scholar
  • 145 Ford C N, Battaglia D G, Gentry L R. Preservation of periosteal attachment in lateral osteotomy.  Ann Plast Surg. 1984;  13 107
    CrossrefPubMedGoogle Scholar
  • 146 Murakami C S, Larrabee W E. Comparison of osteotomy techniques in the treatment of nasal fractures.  Facial Plast Surg. 1992;  8 209
    Article in Thieme ConnectPubMedGoogle Scholar
  • 147 Gryskiewicz J M, Gryskiewicz K M. Lateral Osteotomies: A Clinical Comparison of the Perforating Methods versus the continuous Technique.  Plast Reconstr Surg. 2004;  113 1445-1456
    CrossrefPubMedGoogle Scholar
  • 148 Rohrich R J, Janis J E, Adams W P, Krueger J K. Update on the LateraI Nasal Osteotomy in Rhinoplasty: An Anatomic endoscopic comparison of the External versus the internal Approach.  Plast Reconstr Surg. 2003;  111 2461-2462
    CrossrefPubMedGoogle Scholar
  • 149 Gryskiewicz J M. Visible scars from percutaneous osteotomies.  Plast Reconstr Surg. 2005;  116 1771-1775
    CrossrefPubMedGoogle Scholar
  • 150 Minoli J J. Update on the Lateral Nasal Osteotomy in Rhinoplasty: An Atomic Endoscopic Comparison of the External versus the Approach (Discussion).  Plast Reconstr Surg. 2003;  111 2463
    CrossrefPubMedGoogle Scholar
  • 151 Becker D G, McLaughlin Jr R B, Loevner L A, Mang A. The Lateral Osteotomy in Rhinoplasty: Clinical und Radiographic Rationale for Osteotome Selection.  Plast Reconstr Surg. 2000;  105 1806
    CrossrefPubMedGoogle Scholar
  • 152 Kuran I, Ozcan H, lista A, Bos L. Comparison of four different types of osteotomes for lateral osteotomy: A cadaver study.  Aesthetic Plast Surg.. 1996;  20 323
    CrossrefPubMedGoogle Scholar
  • 153 Thomas J R, Griner N R, Remmler D J. Steps for a safer method of osteotomies in rhinoplasty.  Laryngoscope. 1987;  97 746
    PubMedGoogle Scholar
  • 154 Rohrich R J, Gunter J P, Deuber M A, Adams Jr W P. The deviated nose: optimizing results using a simplified classification and algorithmic approach.  Plast Reconstr Surg. 2002;  110 1509-1523
    CrossrefPubMedGoogle Scholar
  • 155 Guyuron B, Behmand R A. Caudal nasal deviation.  Plast Reconstr Surg. 2003;  111 2449-2457
    CrossrefPubMedGoogle Scholar
  • 156 Pontius A T, Williams 3rd  E F. Endonasal placement of spreader grafts in rhinoplasty.  Ear Nose Throat J. 2005;  84 135-136
    PubMedGoogle Scholar
  • 157 Rohrich R J, Griffin J R. Correction of intrinsic nasal tipp asymmetries in primary rhinoplasty.  Plast Reconstr Surg. 2003;  112 1699-1712
    CrossrefPubMedGoogle Scholar
  • 158 Riechelmann H, Rettinger G. Three-step reconstruction of complex saddle nose deformities.  Arch Otolaryngol Head Neck Surg. 2004;  130 334-338
    CrossrefPubMedGoogle Scholar
  • 159 Gunter J R, Clark C R, Friedman R M. Internal stabilization of autogenous rib cartilage: A barrier to cartilage warping.  Plast Reconstr Surg. 1997;  100 161
    CrossrefPubMedGoogle Scholar
  • 160 Constantian M B. The two essential elements for planning tipp surgery in primary and secondary rhinoplasty: observations based on review of 100 consecutive patients.  Plast Reconstr Surg. 2004;  114 1571-1581
    PubMedGoogle Scholar
  • 161 Kuran I, Tumerdem B, Tosun U, Yildiz K. Evaluation of the effects of tip-binding sutures and cartilaginous grafts on tipp projection and rotation.  Plast Reconstr Surg. 2005;  116 282-288
    CrossrefPubMedGoogle Scholar
  • 162 Tasman A J. Der infrakartilaginäre Zugang zur Nasenspitze.  Laryngo-Rhino-Otologie. 2004;  84 234-238
    Article in Thieme ConnectPubMedGoogle Scholar
  • 163 Adamson P A, Galli S K. Rhinoplasty approaches: current state of the art.  Arch Facial Plast Surg. 2005;  7 32-37
    CrossrefPubMedGoogle Scholar
  • 164 Teichgraeber J F, Riley W B, Russo R C. External rhinoplasties: indications for use.  Br J Plast Surg. 1992;  45 47-54
    CrossrefPubMedGoogle Scholar
  • 165 Stoll W. 5 years experience with „open septorhinoplasty”.  Laryngo-Rhino-Otologie. 1991;  70 171-176
    PubMedGoogle Scholar
  • 166 Adant J P, Bluth F, Fisette J. External rhinoplasty: a useful approach for a young plastic surgeon.  Ann Chir Plast Esthet. 1998;  43 635-648
    PubMedGoogle Scholar
  • 167 Smith O, Goodman W. Open rhinoplasty: its past and future.  J Otolaryngol. 1993;  22 21-25
    PubMedGoogle Scholar
  • 168 Gruber R P, Friedman G D. Suture algorithm for the broad or bulbous nasal tip.  Plast Reconstr Surg. 2002;  110 1752-1764
    CrossrefPubMedGoogle Scholar
  • 169 Adamson P A. Incision and scar analysis in open (external) rhinoplasty.  Arch Otolaryngol Head Neck Surg. 1990;  116 671-675
    CrossrefPubMedGoogle Scholar
  • 170 Foda H M. External rhinoplasty: a critical analysis of 500 cases.  J Laryngol Otol. 2003;  117 473-477
    CrossrefPubMedGoogle Scholar
  • 171 Guerrerosantos J. Open rhinoplasty without skin-columella incision.  Plast Reconstr Surg. 1990;  85 955-960
    CrossrefPubMedGoogle Scholar
  • 172 Bafaqeeh S A, al-Qattan M M. Alterations in nasal sensibility following open rhinoplasty.  Br J Plast Surg. 1998;  51 508
    CrossrefPubMedGoogle Scholar
  • 173 Adams W P, Rohrich R J, Hollier L H, Minoli J, Thornton L K, Gyimesi I. Anatomic basis and clinical implications for nasal tip support in open versus closed rhinoplasty.  Plast Reconstr Surg. 1999;  103 255-261
    CrossrefPubMedGoogle Scholar
  • 174 Kastenbauer E. Was hat sich geändert in der funktionell-ästhetischen Rhinochirurgie?.  Laryngorhinootologie. 1989;  68 4-11
    PubMedGoogle Scholar
  • 175 Aiach G. Mini-forum: rhinoplasty by external approach. External or endonasal approach for rhinoplasty?.  Ann Chir Plast Esthet. 1992;  37 498-509
    PubMedGoogle Scholar
  • 176 Draf W, Schauss F. External rhinoplasty: its role in aesthetic and functional surgery of the nose.  Facial Plast Surg. 1995;  11 228-236
    PubMedGoogle Scholar
  • 177 Cardenas-Camarena L, Guerrero M T. Improving nasal tip projection and definition using interdomal sutures and open approach without transcolumellar incision.  Aesthetic Plast Surg. 2002;  26 161-166
    CrossrefPubMedGoogle Scholar
  • 178 Sheen J H. Closed versus open rhinoplasty - and the debate goes on.  Plast Reconstr Surg. 1997;  99 859-862
    CrossrefPubMedGoogle Scholar
  • 179 Anderson J R. A reasoned approach to nasal base surgery.  Arch Otolaryngol. 1984;  110 349-358
    PubMedGoogle Scholar
  • 180 Beaty M M, Dyer 2nd  W K, Shawl M W. The quantification of surgical changes in nasal tip support.  Arch Facial Plast Surg. 2002;  4 82-91
    CrossrefPubMedGoogle Scholar
  • 181 Rohrich R J, Adams W P. The boxy nasal tip: Classification and management based on alar cartilage suturing techniques.  Plast Reconstr Surg. 2001;  107 1849
    CrossrefPubMedGoogle Scholar
  • 182 Daniel R K. Rhinoplasty: A simplified, three-stitch, open tip suture technique. Part I: Primary rhinoplasty.  Plast Reconstr Surg. 1999;  103 1491
    CrossrefPubMedGoogle Scholar
  • 183 Tebbetts J B. Shaping and positioning the nasal tip without structural disruption: A new, systematic approach.  Plast Reconstr Surg. 1994;  94 61
    CrossrefPubMedGoogle Scholar
  • 184 Behmand R A, Ghavami A, Guyuron B. Nasal tip sutures: Part I. The evolution.  Plast Reconstr Surg. 2003;  112 1125
    CrossrefPubMedGoogle Scholar
  • 185 Guyuron B, Behmand R A. Nasal tip sutures. part II. The interplays.  Plast Reconstr Surg. 2003;  112 1130
    CrossrefPubMedGoogle Scholar
  • 186 Tebbetts J B. Rethinking the logic and techniques of primary tip rhinoplasty. A perspective of the evolution of surgery of the nasal tip.  Clin Plast Surg. 1996;  23 245-253
    PubMedGoogle Scholar
  • 187 Calderon-Cuellar L T, Trujillo-Hernandez B, Vasquez C, Padilla-Acero J, Cisneros-Preciado H. Modified mattress suture technique to correct anterior septal deviation.  Plast Reconstr Surg. 2004;  114 1436-1441
    PubMedGoogle Scholar
  • 188 Gruber R P, Nahai F, Bogdan M A, Friedman G D. Changing the Convexity and Concavity of Nasal cartilages and cartilage grafts with horizontal mattress sutures: Part II. Clinical Results.  Plast Reconstr Surg. 2005;  115 595-606
    CrossrefPubMedGoogle Scholar
  • 189 Rohrich R J, Friedman R M, Liland D L. Comparison of otoplasty techniques in the rabbit model.  Ann Plast Surg. 1995;  34 43
    PubMedGoogle Scholar
  • 190 Gruber R P, Nahai F, Bogdan M A, Friedman G D. Changing the convexity and concavity of nasal cartilages and cartilage grafts with horizontal mattress sutures: part I. Experimental results.  Plast Reconstr Surg. 2005;  115 589-594
    CrossrefPubMedGoogle Scholar
  • 191 Meyer R, Jovanovic B, Derder S. All about nasal valve collapse.  Aesthetic Plast Surg. 1996;  20 141
    PubMedGoogle Scholar
  • 192 Schlosser R J, Park S S. Functional nasal surgery.  Otolaryngol Clin North Am. 1999;  32 37
    CrossrefPubMedGoogle Scholar
  • 193 Ozturan O, Miman M C, Kizilay A. Bending of the upper lateral cartilages for nasal valve collapse.  Arch Facial Plast Surg. 2002;  4 258
    CrossrefPubMedGoogle Scholar
  • 194 Park S S. The flaring suture to augment the repair of the dysfunctional nasal valve.  Plast Reconstr Surg. 1998;  101 1120
    CrossrefPubMedGoogle Scholar
  • 195 Cardenas J C, Carvajal J, Ruiz A. Securing nasal tipp rotation through suspension suture technique.  Plast Reconstr Surg. 2006;  117 1750-1755
    CrossrefPubMedGoogle Scholar
  • 196 Goldman I B. Surgical tips on the nasal tip.  Eye Ear Nose Throat Mon. 1954;  33 583-591
    PubMedGoogle Scholar
  • 197 Davis A M, Simons R L, Rhee J S. Evaluation of the Goldman Tip Procedure in Modern-Day Rhinoplasty.  Arch Facial Plast Surg. 2004;  6 301-308
    CrossrefPubMedGoogle Scholar
  • 198 Foda H M, Kridel R W. Lateral crural steal and lateral crural overlay: an objective evaluation.  Arch Otolaryngol Head Neck Surg. 1999;  125 1365-1370
    CrossrefPubMedGoogle Scholar
  • 199 Pastorek N J, Bustillo A, Murphy M R, Becker D G. The extended columellar strut-tip graft.  Arch Facial Plast Surg. 2005;  7 176-184
    CrossrefPubMedGoogle Scholar
  • 200 Rohrich R J, Raniere Jr J , Ha R Y. The alar contour graft: correction and prevention of alar rim deformities in rhinoplasty.  Plast Reconstr Surg. 2002;  109 2495-2505
    CrossrefPubMedGoogle Scholar
  • 201 Collawn S S, Fix R J, Moore J R, Vasconez L O. Nasal cartilage grafts: more than a decade of experience.  Plast Reconstr Surg. 1997;  100 1547
    CrossrefPubMedGoogle Scholar
  • 202 Constantian M B. Functional effects of alar cartilage malposition.  Ann Plast Surg. 1993;  30 487
    CrossrefPubMedGoogle Scholar
  • 203 Foda H M. Management of the droopy tip: a comparison of three alar cartilage-modifying techniques.  Plast Reconstr Surg. 2003;  112 1408-1417
    CrossrefPubMedGoogle Scholar
  • 204 Gruber R P. Primary open rhinoplasty. In: Gruber RP, Peck GC (eds) Rhinoplasty State of the Art. St. Louis; Mosby-Year Book 1993
    Google Scholar
  • 205 Walter C. Plastisch-chirurgische Eingriffe im Kopf-Halsbereich. Stuttgart; Thieme 1997
    Google Scholar
  • 206 Boccieri A. Mini spreader grafts: a new technique associated with reshaping of the nasal tip.  Plast Reconstr Surg. 2005;  116 1525-1534
    CrossrefPubMedGoogle Scholar
  • 207 Gruber R P. The short nose.  Clin Plast Surg. 1996;  23 297-313
    PubMedGoogle Scholar
  • 208 Peck G C. The onlay graft for nasal tip projection.  Plast Reconstr Surg. 1983;  71 27
    PubMedGoogle Scholar
  • 209 Sheen J H. Secondary rhinoplasty.  Plast Reconstr Surg. 1975;  56 137
    PubMedGoogle Scholar
  • 210 Hamra S T. Lengthening the foreshortened nose.  Plast Reconstr Surg. 2001;  108 547-549
    CrossrefPubMedGoogle Scholar
  • 211 Guyuron B, Varghai A. Lengthening the nose with a tongue-and-groove technique.  Plast Reconstr Surg. 2003;  111 1533-1539
    CrossrefPubMedGoogle Scholar
  • 212 Constantian M B. The boxy nasal tip, the ball tip, and alar cartilage malposition: variations on a theme - a study in 200 consecutive primary and secondary rhinoplasty patients.  Plast Reconstr Surg. 2005;  116 268-281
    CrossrefPubMedGoogle Scholar
  • 213 Smith R A, Smith E T. A new technique in nasal-tip reduction surgery.  Plast Reconstr Surg. 2001;  108 1798-1804
    CrossrefPubMedGoogle Scholar
  • 214 Oxford Centre for Evidence-based Medicine .May 2001.  http://www.cebm.net 10..8..2006
    Google Scholar
  • 215 Ching S, Thoma A, McCabe R E, Antony M M. Measuring outcomes in aesthetic surgery: a comprehensive review of the literature.  Plast Reconstr Surg. 2003;  111 469-480
    CrossrefPubMedGoogle Scholar

Priv.-Doz. Dr. med. Abel-Jan Tasman

HNO-Klinik, Hals- und Gesichtschirurgie
Kantonsspital St. Gallen

Rorschacher Str. 95
CH-9007 St. Gallen

Email: abel-jan.tasman@kssg.ch