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Related Concept Videos

Epistaxis01:30

Epistaxis

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Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
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Nose and Nasal Cavity01:24

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The nose is composed of an observable exterior segment (external nose) and an internal segment within the skull known as the nasal cavity (internal nose). The external nose, visible on the face, consists of a framework of bone and hyaline cartilage enveloped in skin and muscle and lined with a mucous membrane. This structure is supported by the frontal bone, nasal bones, and maxillary bone and is supplemented by a cartilaginous framework comprising the septal nasal cartilage, lateral nasal...
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Cranial Bones: Lateral View01:27

Cranial Bones: Lateral View

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The lateral view of the cranium is dominated by temporal, sphenoid, and ethmoid bones.
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...
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Suctioning the Nasopharyngeal Airway01:29

Suctioning the Nasopharyngeal Airway

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Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
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Tracheostomy Decannulation01:21

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Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
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Updated: Jan 17, 2026

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

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Closed Structural Rhinoplasty.

Richard P Clark1, Matthew M Farajzadeh2, Granger B Wong2

  • 1Private Practice, Sacramento, CA, USA. rclarkmd@cwo.com.

Aesthetic Plastic Surgery
|September 16, 2025
PubMed
Summary
This summary is machine-generated.

Closed rhinoplasty techniques allow for tip restructuring without columella scarring. This approach offers an alternative to open rhinoplasty, with a low incidence of noticeable scars reported by surgeons.

Keywords:
ClosedEndonasalRhinoplastyStructural

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Area of Science:

  • Plastic Surgery
  • Rhinoplasty Techniques
  • Surgical Innovation

Background:

  • Closed rhinoplasty was historically limited in providing structural tip support.
  • Open rhinoplasty, despite a visible scar, is preferred by many surgeons for complex tip work.
  • Pioneering surgeons have demonstrated excellent results with closed rhinoplasty, though open techniques remain prevalent.

Purpose of the Study:

  • To describe endonasal methods for replicating open rhinoplasty tip suturing techniques.
  • To demonstrate closed rhinoplasty suture passing and grafting techniques via video.
  • To assess the incidence of columella scar complications from open rhinoplasty.

Main Methods:

  • Development of novel endonasal tip suturing techniques over 39 years.
  • Detailed description and video demonstration of closed rhinoplasty tip grafting and suturing.
  • A survey of American Society of Plastic Surgeons (ASPS) members regarding columella scar visibility.

Main Results:

  • Original closed rhinoplasty suture techniques were successfully demonstrated through videos and photographs.
  • A survey indicated that 11% of ASPS surgeons reported noticeable columella scars in over 25% of their patients at close range.
  • The developed closed rhinoplasty techniques effectively address tip support and structure.

Conclusions:

  • Tip restructuring using permanent sutures is feasible through closed rhinoplasty.
  • The described endonasal delivery technique avoids problematic columella scarring.
  • Closed rhinoplasty offers a scarless alternative for achieving sophisticated nasal tip results.