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Triangular Resection of the Upper Lateral Cartilage for Middle Vault Deviation.

Gwanghui Ryu1, Min Young Seo1, Kyung Eun Lee1

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Clinical and Experimental Otorhinolaryngology
|June 2, 2018
PubMed
Summary

A novel triangular resection technique effectively corrects middle vault deviation in rhinoplasty. This method improves nasal aesthetics and function by balancing upper lateral cartilage (ULC) without causing nasal valve narrowing.

Keywords:
Acquired Nasal DeformitiesNasal CartilagesNoseRhinoplasty

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Area of Science:

  • Plastic Surgery
  • Rhinology
  • Facial Plastic Surgery

Background:

  • Middle vault deviation significantly impacts nasal aesthetics and function.
  • Existing techniques like spreader grafts have limitations in addressing upper lateral cartilage (ULC) surplus and balance.
  • A need exists for refined surgical methods to manage middle vault deviation.

Purpose of the Study:

  • To introduce a new surgical technique: triangular resection of the ULC.
  • To evaluate the efficacy of this triangular resection for correcting middle vault deviation.
  • To assess both aesthetic and functional outcomes post-surgery.

Main Methods:

  • Retrospective study of 17 patients with middle vault deviation undergoing septorhinoplasty.
  • Application of the novel triangular resection technique for ULC management.
  • Pre- and postoperative evaluation using medical photographs, acoustic rhinometry, and subjective nasal obstruction scores.

Main Results:

  • Significant reduction in nasal tip deviation angle (5.66º to 2.37º immediately, 2.49º long-term).
  • Improvement in middle vault deviation (169.50º to 177.24º immediately, 178.68º long-term).
  • Enhanced nasal cross-sectional area and reduced subjective nasal obstruction scores.

Conclusions:

  • Triangular resection of the ULC is a simple and effective technique for middle vault deviation.
  • The method successfully balances ULCs without causing internal nasal valve narrowing.
  • Offers a promising solution for improving both nasal form and breathing.