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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Minimally invasive techniques in rhinoplasty.

Holger G Gassner1,2, Ashish A Magdum1, Abel-Jan Tasman3

  • 1Finesse Center for Facial Plastic Surgery Regensburg.

Current Opinion in Otolaryngology & Head and Neck Surgery
|July 7, 2020
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Summary

Minimally invasive rhinoplasty techniques minimize tissue injury and incision size using endoscopic approaches. Specific endonasal techniques and precise osteotomies best meet these criteria for reduced patient trauma.

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Area of Science:

  • Plastic Surgery
  • Surgical Innovation
  • Facial Anatomy

Background:

  • Rhinoplasty involves significant tissue manipulation of both soft and skeletal nasal structures.
  • Surgical trauma can occur through various mechanisms including mechanical forces and thermal injury.
  • Assessing the minimally invasive nature of rhinoplasty techniques requires evaluating the extent of the approach and tissue dissection.

Purpose of the Study:

  • To define criteria for minimally invasive surgery in rhinoplasty.
  • To analyze current rhinoplasty techniques based on their minimally invasive characteristics.
  • To identify techniques that best align with minimally invasive surgical principles.

Main Methods:

  • Review of recent publications on rhinoplasty techniques.
  • Analysis of surgical approaches, dissection planes, and osteotomy methods.
  • Evaluation of endoscopic applications in rhinoplasty.

Main Results:

  • Nasal structure comprises approximately 60% soft tissue and 40% skeletal elements.
  • Techniques like single-incision endonasal approaches, specific dissection planes (subperichondrial, subperiosteal), and limited undermining with endoscopic visualization were identified.
  • Various osteotomy methods (percutaneous, piezo, drill) and contouring techniques were assessed for their minimally invasive potential.

Conclusions:

  • A single endonasal incision approach is optimal for minimally invasive rhinoplasty.
  • Specific dissection planes and advanced osteotomy techniques (piezo, percutaneous) best fulfill minimally invasive criteria.
  • A proposed classification system can guide the assessment of minimally invasive rhinoplasty techniques.