External valve deformity: correction by composite flap elevation and mattress sutures

Area of Science:

• Plastic Surgery
• Otolaryngology
• Rhinoplasty Techniques

Background:

• External nasal valve deformities, specifically lateral crus curling, are a complication of rhinoplasty.
• These deformities can cause airway obstruction and aesthetic concerns.
• Conventional correction methods using grafts can be complex and lead to bulkiness.

Purpose of the Study:

• To introduce and evaluate a novel surgical technique for correcting posterior lateral crus deformities.
• To assess the efficacy of this technique in improving both functional and aesthetic outcomes.

Main Methods:

• A U-shaped incision creates a medially based composite flap of the lateral crus.
• Horizontal mattress sutures are applied to the flap's convex surface to straighten the cartilage.
• The flap is repositioned to correct the deformity.

Main Results:

• Seven patients underwent correction using the composite flap and mattress suture technique.
• Follow-up ranged from 10 to 33 months.
• Successful aesthetic and functional correction was achieved in six out of seven patients; one required a secondary symmetry procedure.

Conclusions:

• Medially based composite flap elevation provides excellent control over lateral crus shape.
• Mattress sutures enhance cartilage stiffness and strength.
• This technique offers a straightforward solution for complex lateral crus deformities.