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Related Experiment Video

Updated: Jun 26, 2026

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
06:13

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

Published on: June 20, 2018

Nasal base reduction by alar release: a laboratory evaluation.

Ronald P Gruber1, M Brandon Freeman, Charles Hsu

  • 1Stanford, San Francisco, and Davis, Calif.; and Providence, R.I. From the Divisions of Plastic and Reconstructive Surgery of Stanford University, University of California, San Francisco, Brown University, and University of California, Davis.

Plastic and Reconstructive Surgery
|February 3, 2009
PubMed
Summary

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This study on cadavers found that releasing specific soft tissues around the pyriform ligament significantly reduces nasal base width. This technique offers a way to achieve tension-free alar medialization in rhinoplasty.

Area of Science:

  • Plastic Surgery
  • Anatomy
  • Rhinology

Background:

  • Resection of nasal base soft tissue has limits, risking distortion and nostril stenosis.
  • Alar mobilization via freeing soft-tissue attachments is crucial for nasal base reduction.
  • Understanding these attachments is key to safe and effective alar medialization.

Purpose of the Study:

  • To investigate the anatomical attachments of the nasal ala.
  • To determine the extent of medialization achievable by releasing these attachments.
  • To evaluate the role of the pyriform ligament and surrounding periosteum in nasal base stability.

Main Methods:

  • Sequential division of alar supporting tissues in 16 fresh hemifacial cadavers.
  • Targeted release of: anterior maxilla soft tissues/pyriform ligament, posterior periosteum in nasal vault, and horizontal pyriform rim soft tissues.

Related Experiment Videos

Last Updated: Jun 26, 2026

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
06:13

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

Published on: June 20, 2018

  • Measurement of ala-pyriform distance after each release step.

    • Main Results:

    • Releasing anterior maxillary periosteum/pyriform ligament reduced distance by 1.9 mm.
    • Releasing posterior periosteum reduced distance by 1.7 mm.
    • Releasing horizontal pyriform rim soft tissues reduced distance by 1.0 mm, totaling 4.6 mm. Anterior/posterior releases yielded significantly greater medialization.

    Conclusions:

    • Cadaver study confirms the stabilizing role of the pyriform ligament and periosteum.
    • Complete release achieved substantial medialization.
    • This suggests a clinical method for tension-free alar medialization in nasal surgery.