Mohammed, H., Miteab, R. (2023). Evaluation of the Functional and Aesthetic Outcomes of Alar Base Reduction in Patients of Primary Open Septorhinoplasty. Alustath, 22(3), 251-260. doi: 10.52573/ipmj.2023.181128
Hamza Mehdy Mohammed; Ragheed Turky Miteab. "Evaluation of the Functional and Aesthetic Outcomes of Alar Base Reduction in Patients of Primary Open Septorhinoplasty". Alustath, 22, 3, 2023, 251-260. doi: 10.52573/ipmj.2023.181128
Mohammed, H., Miteab, R. (2023). 'Evaluation of the Functional and Aesthetic Outcomes of Alar Base Reduction in Patients of Primary Open Septorhinoplasty', Alustath, 22(3), pp. 251-260. doi: 10.52573/ipmj.2023.181128
Mohammed, H., Miteab, R. Evaluation of the Functional and Aesthetic Outcomes of Alar Base Reduction in Patients of Primary Open Septorhinoplasty. Alustath, 2023; 22(3): 251-260. doi: 10.52573/ipmj.2023.181128

Evaluation of the Functional and Aesthetic Outcomes of Alar Base Reduction in Patients of Primary Open Septorhinoplasty

Iraqi Postgraduate Medical Journal
Article 3, Volume 22, Issue 3, July 2023, Pages 251-260    PDF (709.42 K)
DOI: 10.52573/ipmj.2023.181128
Authors
Hamza Mehdy Mohammed* 1; Ragheed Turky Miteab2
1Al Furat General Hospital, Baghdad, Iraq
2Department of Otolaryngology /Ghazi Al-Hariri Hospital for Surgical Specialties -Medical City Complex, Baghdad, Iraq
Abstract
BACKGROUND:
Open septorhinoplasty is one of the most challenging procedures in facial plastic surgery and consideration must be given to both facial aesthetics and nasal function.
OBJECTIVE:
To evaluate the functional and the aesthetic outcomes of alar base reduction techniques in patients of primary open septorhinoplasty.
PATIENTS AND METHOD:
A prospective, descriptive study had been conducted from the first of  April 2018 to the first of April 2019 at the Center of Otolaryngology- Head and Neck surgery at Ghazy AL-Hariry Medical City Hospital, 40 patients were selected (28 females and 12 males) who underwent primary open septorhinoplasty. All patients were evaluated by questionnaire, subjective assessment, clinical examination and photo documentation both pre and post-operatively quantitatively analyzed using image J processing software for objective assessment, with follow up at first, third and sixth month post-operatively and three types of operations techniques were used to reduce the wide nasal base.
RESULTS:
Among the 40 patients, the mean ratio of inter-alar distance to inter-canthal distance changed significantly from (1.234) to (1.034), the frequency of nostrils symmetry increased from (18) patients to (33) patients, the frequency of nasal flaring decreased from 30 patients to only 7 patients, the mean width of the internal vestibular resection was 3.675 mm and the mean width of the external alar wedge resection was 4.45mm. All the patients were satisfied in varying degrees and no worsening of the functional outcomes postoperatively assessed subjectively.  No cases of postoperative bleeding, infection, vestibular stenosis, keloid, hypertrophic scar formation or nasal obstruction were encountered.
CONCLUSION:
A conservative excision is preferred to a radical one because it is a simple matter to resect additional alar tissue than reconstruct a stenotic ala. Alar base reduction techniques are effective techniques for patient with wide alar base and/or alar flaring with good outcomes regarding patients’ satisfaction and without worsening of the functional outcomes. The internal vestibular floor resection that is inclined 30-45 degrees laterally together with placement of the external alar resection in the natural alar facial crease result in natural curvature of the alar rim and an inconspicuous scar.
 
Keywords
Alar base reduction; Alar flaring; Septorhinoplasty
References
  1. Vasilakis, V., Isakson, M.H., Kortesis, B.G. et al. The cinch suture nasal sill excision combination technique for nasal base reduction in rhinoplasty,2020, Eur J Plast Surg 43, 713–718.
  2. Koç B., Bayar Muluk N., Choi J.Y. Alar Base Surgery. In: Cingi C., Bayar Muluk N. (eds) All Around the Nose. Springer, Cham;2020 : 871-77.
  3. Hahn S, Lee J, Friedman O. principles of rhinoplasty. In: Sataloff RT, Sclafani AP. Sataloff’s comprehensive textbook of otolaryngology head & neck surgery - facial plastic and reconstructive surgery. 1st ed. Japypee The Health Sciences Publishers; 2016: 429.
  4. Alsarraf R. Outcomes research in facial plastic surgery: a review and new directions. Aesthetic Plast Surg. 2000; 24:192-97.
  5. Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg. 2004; 130:157-63.
  6. Rego LF, Arroyo HH, Parisi JR. Update in alar base reduction in rhinoplasty. Curr Opin Otolaryngol Head Neck Surg 2016;24:1-5.
  7. Foda HMT. Alar base reduction: the boomerang-shaped excision. Facial Plast Surg 2011; 27:225–33.
  8. Kridel RWH, Castellano RD. A simplified approach to alar base reduction: a review of 124 patients over 20 years. Arch Facial Plast Surg 2005;7:81–93.
  9. Warner JP, Chauhan N, Adamson PA. Alar soft-tissue techniques in rhinoplasty: algorithmic approach, quantifiable guidelines, and scar outcomes from a single surgeon experience. Arch Facial Plast Surg 2010;12:149–58.
  10. Ohba N, Ohba M. Preservation of nostril morphology in nasal base reduction. Aesthetic plastic surgery. 2016;40:680-84.
  11. Kim JH, Park JP, Jang YJ. Aesthetic outcomes of alar base resection in Asian patients undergoing rhinoplasty. JAMA facial plastic surgery. 2016;18:462-66.
  12. Bennett GH, Lessow A, Song P, Constantinides M. The long-term effects of alar base reduction. Archives of facial plastic surgery. 2005;7:94.
  13. Ismail AS. Nasal base narrowing: the alar flap advancement technique. Otolaryngology--Head and Neck Surgery. 2011; 144:48-52.
 

 

Statistics
Article View: 58
PDF Download: 54


Journal Management System. Powered by ejournalplus.com