• Archives of Plastic Surgery
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• 제32권6호
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• pp.791-795
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• 2005

A symmetric approach, using external rhinoplasty, is presented to aid the plastic surgeon in obtaining improved aesthetic and functional results in patients with postoperative nasal deformities. The external approach yields a full visualization of the underlying nasal framework and intraoperative evaluation of the deformities to be corrected subsequently. The nasal septal cartilage is unequivocally one of the best graft sources for reconstruction of the dorsum, columella or tip. It has fairly even surface and pliability in carving and shaping the graft. The graft can be obtained during the surgery with less morbidity and prepared easily for need of the shape. The only real disadvantage is the limited amount of cartilage that can be obtained from the septum. The dorsal and caudal rims, one or more cm in width, of the nasal septum should not be disturbed to maintain the nasal frame during harvesting the septal graft. Authors invented novel instruments, J & D knife and Flat (Spatula) suction tip, and have employed the devices for harvesting the septal cartilage. We were unable to gain enough amount of the cartilage by using a swivel knife or cartilage scissors. The septal cartilage can be resected as much as needed with newly invented instruments which facilitate a separation(method) technique.

• 대한두개안면성형외과학회지
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• 제22권2호
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• pp.85-92
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• 2021

Background: Patients with secondary deformities associated with unilateral cleft lip and nose might also suffer from nostril stenosis due to a lack of tissue volume in the nostril on the cleft side. Here, we used full-thickness skin grafts (FTSGs) to reduce nostril stenosis and various methods for skin volume augmentation. We compared the changes in the symmetry of both nostrils before and after surgery. Methods: From February 2016 to January 2020, 34 patients underwent secondary cheiloplasty and open rhinoplasty for secondary deformities of the unilateral cleft lip and nose with nostril stenosis. FTSG was used on the nostril floor, nasal columella, and alar inner lining. The measured nasal profile included the nostril surface, nostril circumference, width of the nostril floor, and distance from the alar-facial groove to the nasal tip. The "overlap area," which was defined as the largest overlapping area when the image of the cleft nostril was flipped to the left and right and overlaid on the image of the normal side nostril, was also calculated. The degree of symmetry was evaluated by dividing the value of the cleft side by that of the normal side of each measured profile and expressed as "ratios." Results: The results of all profile ratios, except for the nostril floor width, became significantly close to 1, which represents full symmetry. The overlap area ratio improved from 62.7% to 77.3%, meaning that the length and width of the nostril as well as the overall shape became similar (p< 0.05). Conclusion: When performing cleft rhinoplasty with nostril stenosis, FTSG is useful to achieve symmetry in the nostril size and shape. Skin grafting is simpler to perform than the other types of local flap, and the results are generally satisfactory.

• Archives of Plastic Surgery
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• 제32권2호
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• pp.205-213
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• 2005

There are several characteristics of the nose of orientals. The dorsum of nose is flat and low, the skin is thick with severe tension, the nasal tip is bulbous, the nostril is wide, and the projection of the nose is limited due to a poorly developed alar cartilage with a short columella. In order to improve these untoward characteristics of the nose of Orientals aesthetically, plain augmentation of the dorsum and tip-plasty with conventional methods has been performed by many plastic surgeons. However these conventional rhinoplasty is not enough to obtain satisfactory results when transforming into a more beautiful and aesthetically charming appearance. In order to produce the optimal nasal shape and profile, it is extremely important to consider the aesthetic surgical factors, which are; the position of the nasion, the optimal nasolabial angle(95-100 degree in Orientals), the natural exposure of infra-tip lobule with and columella, the position of the tip defining point in harmony with the dorsal profile and the smooth and natural silhouette of the lateral nasal profile as it descends into the inferior portion of the nose. From April, 2003 to August, 2004, a total of 52 patients underwent open rhinoplasty, adhering to the strict aesthetic principles considered and described priorly. Surgical approach was done through a transcolumella incision and an alar rim incision. The nasal dorsum was augmented with a silicone implant and the shape of the columella and the nasolabial angle were finessed with a silicone strut implant which was placed in between the medial crurae in a manner of a non-visible graft. The nasal tip was corrected by alar cartilage suture technique and onlay graft of shield shaped Alloderm and Gore-Tex. Author obtained the optimal nasal shape and profile aesthetically, and the results, considered satisfactory in all patients without any complications, are as follows; 1. the average increase in nasal length was 2.5 mm, 2. the average decrease in nasal width was 2.1 mm, 3. the average increase in nasal tip projection was 3.2 mm, 4. the changes of nasolabial angles were from 85.5 degree to 94.7 degree, 5. the changes of the angle between the long axis of the external naris was from 101.3 degree to 89.5 degree. In conclusion, this surgical procedure is an effective, reliable and a valuable method in improving the nasal shape, tip projection, nasolabial angle and especially, the lateral facial profile of Orientals aesthetically.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.623-628
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• 2009

Purpose: In cases where nasal fractures involve frontal process of maxilla or perpendicular plate of ethmoid, 4 - 5 days of nasal packing may not provide sufficient support for avoiding displacement after packing removal. Therefore a single Kirschner - wire(K - wire) is used as an internal splint when nasal fractures involve the above two areas. Methods: Thirty five patients during the last 3 practical years were treated with a K -wire pinning according to the anatomic locations of nasal fractures. We performed a retrospective study using 13 nasal fractures out of total 35 patients. Among 13 cases, 10 patients involved frontal process of maxilla, and 3 patients were diagnosed as bilateral nasal side wall fractures accompanied with fractures of perpendicular plate of ethmoid. One patient of the last three cases had been augmented with dorsal silicone implant long before the trauma. We analyzed the anteroposterior displacement of key stone area and the width between both lateral walls by comparing immediate postoperative radiographs with 2 month follow - ups. To reduce the errors, the same measurements were taken by two different inspectors, and the mean of each inspector's measurements was compared. Patient satisfaction was analyzed using a questionnaire regarding the esthetic and functional outcomes. Results: Ten patients underwent a longitudinal K - wire fixation in submucoperiosteal plane underneath the frontal process of maxilla. And three patients underwent a transverse K - wire fixation from the one side of lateral wall to the perpendicular plate of ethmoid and to the other side of lateral wall. The mean postoperative anteroposterior displacement of the key stone area measured by two inspectors were 1.84% and 3.06%; mean narrowing of bony pyramid were 1.33% and 1.48%, respectively. Subjective satisfaction scores regarding the esthetic appearance and the maintenance of nasal shape compared with immediate post - operative state with the long term ones were not different (p>0.05). Conclusion: K - wire pinning after closed reduction is a reliable and useful method for the treatment of nasal fractures involving frontal process of maxilla or perpendicular plate of ethmoid. This is because it achieves longer intranasal support after reduction. This method also leaves conspicuous external scar, and minimal soft - tissue injury.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권4호
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• pp.287-294
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• 2006

The secondary correction of cleft lip nasal deformity (CLND) presents difficult surgical problems. Characteristically, nostrils are asymmetric. The present study was aimed to examine and compare the effect of Straith's alar web Z-plasty, Millard's alar web Z-plasty, alar web excision, and lateral V-Y advancement of the alar base for augmentation of the nostril with or without lengthening the columella in CLND. The subjects were 28 patients with unilateral cleft lip, who had secondary nostril correction. The nostril correction methods were Straith's alar web Z-plasty, Millard's alar web Z-plasty, alar web excision, and lateral V-Y advancement of the alar base. Facial photographs were taken before and 20 days after the operation. By using Adobe photoshop, the columella length and the nostril width were measured from the facial frontal photograph and Worm's eye view. The degree of improvement was calculated and statistically analyzed. The degree of improvement of the columella length using Straith's alar web Z-plasty was 70.20%. And then Millard's alar web Z-plasty was 55.01%, alar web excision was 39.93%, and lateral V-Y advancement of the alar base was 16.38% in order. The degree of improvement of the nostril size using lateral V-Y advancement of the alar base was 55.26%. And then alar web excision was 52.72%, Millard's alar web Z-plasty was 34.86%, and Straith's alar web Z-plasty was 16.06% in order. Straith's alar web Z-plasty and Millard's alar web Z-plasty resulted in elongation of the columella, equalization of asymmetrical nostril, and enlargement of small nostrils. Alar web excision enlarged nostrils and restored symmetry. Lateral VY advancement of the alar base increased nostril width and enlarged nostrils. These results indicate that the correction of nostrils improve the shape and the symmetry of the nostrils in CLND.

• 사상체질의학회지
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• 제10권2호
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• pp.221-270
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• 1998

Objective This research is a study about constitutional diagnosis through the external appearances as a basic principle, and it is for finding shape differences of the ear, eye, nose, mouth according to the Sasang constitution Method We have collected 209 cases of patients of the Sasang Constitutional Department, including employees of the Kyung-Hee Medical Center and took pictures of the frontal view, lateral view, oblique view of face and measured heights, deapth, breadths of ear, eye, nose, mouth with 'The Measurement of R. Martin'. We analyzed shape differences of the face according to the Sasang constitution with certain results Results We got the morphologic characteristics of ear, eye, nose and mouth according to the Sasang constitution as Table 3. -Table 10. Conclusion : 1. The morphologic characteristics of Ear according to the Sasang constitution (1) Morphologic ear length, Physiognomic ear length, Ear lobule length is longer in Taeumin than Soeumin. (2) Physiognomic ear breadth is wider in Taeumin than Soeumin. (3) Physiognomic ear length, lobule length ratio is higher in Taeumin than Soyangin. 2. The morphologic characteristics of Eye according to the Sasang constitution. (1) Inner Palpebral fissure width, 5th Palpebral fissure length, Bizygomatic breadth-Outercanthal distance is the longest in Taeumin (2) Palpebral fissure inclination is widest in Soeumin. (3) Palpebral fissure length is longer in Taeumin than Soeumin. (4) Pupillary diameter ratio is the lowest in Taeumin (5) Palpebral fissure length, width ratio is higher in Soeumin than Taeumin. (6)zygomatic breadth, Bizygomatic breadth-Outercanthal distance ratio is the higher in Taeumin than Soeumin. 3. The morphologic characteristics of Nose according to the Sasang constitution. (1) Nasion depth is deepest in Soyangin. (2) Nasion to pupillary depth is deeper Soyangin than Taeumin. (3) Nasal tip depth, Nostril to Nasalalar depth is deeper Soyangin than Taeumin. (4) Subnasale to Nasalalar depth is the shallowest in Taeumin (5) Nasalalar height is lowest in Soeumin. (6) Nasalalar to Nostril distance is deeper Taeumin than Soeumin. (7) Nasal tip depth, Nasal depth ratio is the highest in Taeumin (8) Nasal depth Nasalalar heightratio is lowest in Soeumin. (9) Midfaceheight, Nasal tip depth ratio is higher Soyangin than Taeumin. 4. The morphologic characteristics of mouth according to the Sasang constitution. (1) Lower mid lip height, Lower philtrum height, Lower quarter lip height, Total middle lip height, Total philtrum height, Total quarter lip height is the shottest in Soyangin. (2) Upper mid lip height, Upper philtrum height is longer in Taeumin than Soyangin (3) Lip inclination is higher in Soeumin than Soyangin. (4) Intercheilion breadth, total height ratio is lowest in Soyangin. (5) Total lip height, Upper philtrum height ratio is higher in Soyangin than Soeumin. (6) Lower lip height Lower quarter lip height ratio is higher in Soyangin than Taeumin. (8) Total lip area is wider in Taeumin than Soyangin.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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• pp.12.2-12
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• 1981

비강 및 부비동에 발생하는 유두종은 비교적 드문 양성종양으로서 수술적 제거후에도 재발이 잘되고 악성화되는 경향이 있는 정도로 알려져 있다. 유두종의 3 Type중 특히 희귀한 균상 유두종은 Microscopically stratified squamous epithelium으로 덮힌 Cornification의 형태를 보이며 출현의 경향은 별로 없는 것으로 알려져 있다. 저자들은 최근 55세 남자의 우측 비강측벽에 발생한 균상유두종 한례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 동의생리병리학회지
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• 제35권6호
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• pp.267-273
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• 2021

Mibyeong (sub-health) is a concept that represents the sub-health in traditional East Asian medicine. Assuming that the nose sizes and shapes are related to respiratory function, in this study, we hypothesized that the nose size and shape features are related to the self-rated health (SRH) level and self-rated Mibyeong severity, and aimed to assess this relationship using a fully automated image analysis system. The nose size features were evaluated from the frontal and profile face images of 810 participants. The nose size features consisted of five length features, one area feature, and one volume feature. The level of SRH and the Mibyeong severity were determined using a questionnaire. The normalized nasal height was negatively associated with the self-rated health score (SRHS) (partial ρ = -0.125, p = 3.53E-04) and the Mibyeong score (MBS) (partial ρ = -.172, p = 9.38E-07), even after adjustment for sex, age, and body mass index. The normalized nasal volume (ρ = -.105, p = 0.003), the normalized nasal tip protrusion length (ρ = -.087, p = 0.014), and the normalized nares width (ρ = -.086, p = .015) showed significant correlation with the SRHS. The normalized nasal area (ρ = -.118, p = 0.001), the normalized nasal volume (ρ = -.107, p = .002) showed significant correlation with the MBS. The wider, longer, and larger the nose, the lower the SRHS and MBS, indicating that health status can be estimated based on the size and shape features of the nose.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권3호
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• pp.284-287
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• 1999

The nose, a striking features of the human face, is regarded by many clinicians as the keystone of facial esthetics. Clinically, as the treatment of a dentofacial deformity, the soft tissue changes that occurred normally with movement of the skeletal bases. Changes of the soft tissue in the maxillary orthognathic surgery are widening of alar base, elevated nasal tip and flattening of upper lip. In addition, soft tissue change is difficult to predict, it has considerable variability in the response of soft tissue. We reviewed patients who received Le Fort I advancement osteotomy in our department and analysed preoperative and postoperative alar base width, nasal height in clinical measurement and cephalometry and patient's satisfaction of postoperative nasal appearance.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제25권4호
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• pp.324-329
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• 1999

The facial esthetics are much affected by nasal changes due to especially its central position in relation to facial outline and so appropriately evaluated should be the functional and esthetic aspects of the nose associated with the facial appearance. Generally, a maxillary surgical movement is known to induce the changes of nasolabial morphology secondary to the skeletal repositioning accompanied by muscular retraction. These changes can be desirable or undesirable to individuals according to the direction and amount of maxillary repositioning. We investigated the surgical changes of bony maxilla and its effects to nasal morphology through the analysis of the lateral cephalogram in the Le Fort I osteotomy. Subjects were 10 patients(male 2, female 8, mean age 22.3 years) and cephalograms were obtained 2 weeks before surgery(T1) and 6 months after surgery(T2). The surgical maxillary movement was identified through the horizontal and vertical repositioning of point A. Soft-tissue analysis of the nasal profile was performed employing two angles: nasal tip projection(NTP), columellar angle(CA). Also, alar base width(ABW) was assessed directly on the patients with a slide gauge. The results were as follows; 1. Both anterior and superior movement above 2mm of maxilla rotated up nasal tip above 1mm. Either anterior or superior movement above 2mm of maxilla made prediction of the amount & direction of NTP changes difficult. Especially, a correlation between horizontal movement of maxilla and NTP rotated-up was P<0.01. 2. Both much highly anterior and superior movement of maxilla is accompanied by more CA increase than either highly. Especially, the correlation between horizontal movement of maxilla and CA change was P<0.05. 3. Anterior and/or superior movement of maxilla was accompanied by the unpredictable ABW widening. 4. The amount of changes of NTP, CA, and ABW is not in direct proportion to amout of anterior and/or superior movement of maxilla. 5. Nasal morphologic changes following Le Fort I osteotomy are affacted by not merely bony repositioning but other multiple factors.