• Home
  • Practice Focus
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
    • How I Do It
    • TRIO Best Practices
  • Business of Medicine
    • Health Policy
    • Legal Matters
    • Practice Management
    • Tech Talk
    • AI
  • Literature Reviews
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Career
    • Medical Education
    • Professional Development
    • Resident Focus
  • ENT Perspectives
    • ENT Expressions
    • Everyday Ethics
    • From TRIO
    • The Great Debate
    • Letter From the Editor
    • Rx: Wellness
    • The Voice
    • Viewpoint
  • TRIO Resources
    • Triological Society
    • The Laryngoscope
    • Laryngoscope Investigative Otolaryngology
    • TRIO Combined Sections Meetings
    • COSM
    • Related Otolaryngology Events
  • Search

SM14: Otolaryngologists Share Surgical Tips on Functional Rhinoplasty

by Thomas R. Collins • February 5, 2014

  • Tweet
  • Email
Print-Friendly Version

You Might Also Like

  • Spreader Graft Placement Found Comparable in Functional Outcome in Patients with Nasal Obstruction
  • Rhinoplasty Experts on Trends in Revision Surgery, Avoiding Legal Pitfalls
  • Irradiated Homologous Costal Cartilage Used Effectively in Rhinoplasty
  • Functional Results Strongly Influence Postoperative Satisfaction in Patients Who Have Undergone Rhinoplasty
Explore This Issue
February 2014

Experts offered tips for navigating challenges in rhinoplaty.

During the session “Technical Pearls for Functional Rhinoplasty,” panelists offered wisdom gathered from years of experience performing the procedure. Here are a few highlights.

Managing the Inferior Turbinate

Alex Chiu, MD, interim chair of surgery and chief of otolaryngology-head and neck surgery at the University of Arizona in Tucson, offered tips for surgery on the inferior turbinate.

A recent study concluded that submucous resection with outfracture, with microdebrider assistance, is the most effective technique for inferior turbinate reduction, said Dr. Chiu (Laryngoscope. Published online ahead of print on September 19, 2013; doi: 10.1002/lary.24182). He advised that everything in the procedure should be done using the endoscope. “Everything in surgery should be with a focus, even putting in cotton pledgets,” he said. “So use an endoscope, [and] de-congest the area you need to work on as opposed to just kind of shoving those pledgets into the nose.”

For the submucous resection, he prefers a linear incision along the inferior turbinate, which helps with exposure, minimizing the chance of getting into trouble with arterial bleeding from the artery located posteriorly along the inferior turbinate.

He also likes epinephrine-soaked pledgets for hemostasis and as a technique for retracting tissue to free mucosa from the bone.

Septoplasty

The trick in septoplasty is creating enough room by modifying the surrounding structures, while preserving enough of the septum itself, said Scott Stephan, MD, assistant professor of otolaryngology at Vanderbilt University in Nashville. “In the modern era there’s more modification of the cartilage in the septum versus in earlier years, [when there was] more of an approach to resect the cartilage,” he said. It’s important to recognize the role of the septum in supporting the middle vault and the tip and to preserve those structural parts of the septum, “much like weight-bearing walls in a house.”

“If you want to modify the septum, you have to know what factors influence it,” he added. Those factors include bone, upper lateral cartilage, and soft tissue. “All of this contributes to a boundary that the septum has to live within, and if you, over time, have too small of a box, then you’re a six-foot man in a five-foot box,” Dr. Stephan said.

Modifying intrinsic features includes resecting bony deviations; modifying the cartilage by scoring the concave side, cross-hatching, and morselizing non-critical areas; and using vertical slats in the dorsum.

Pages: 1 2 3 | Single Page

Filed Under: Facial Plastic/Reconstructive, Features, Practice Focus Tagged With: CSM14, rhinoplastyIssue: February 2014

You Might Also Like:

  • Spreader Graft Placement Found Comparable in Functional Outcome in Patients with Nasal Obstruction
  • Rhinoplasty Experts on Trends in Revision Surgery, Avoiding Legal Pitfalls
  • Irradiated Homologous Costal Cartilage Used Effectively in Rhinoplasty
  • Functional Results Strongly Influence Postoperative Satisfaction in Patients Who Have Undergone Rhinoplasty

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

The Triological SocietyENTtoday is a publication of The Triological Society.

Polls

Have you invented or patented something that betters the field of otolaryngology?

View Results

Loading ... Loading ...
  • Polls Archive

Top Articles for Residents

  • Applications Open for Resident Members of ENTtoday Edit Board
  • How To Provide Helpful Feedback To Residents
  • Call for Resident Bowl Questions
  • New Standardized Otolaryngology Curriculum Launching July 1 Should Be Valuable Resource For Physicians Around The World
  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • The Road Less Traveled—at Least by Otolaryngologists

    • The Best Site for Pediatric TT Placement: OR or Office?

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • Complications for When Physicians Change a Maiden Name

    • Leaky Pipes—Time to Focus on Our Foundations
    • You Are Among Friends: The Value Of Being In A Group
    • How To: Full Endoscopic Procedures of Total Parotidectomy
    • How To: Does Intralesional Steroid Injection Effectively Mitigate Vocal Fold Scarring in a Rabbit Model?
    • What Is the Optimal Anticoagulation in HGNS Surgery in Patients with High-Risk Cardiac Comorbidities?

Follow Us

  • Contact Us
  • About Us
  • Advertise
  • The Triological Society
  • The Laryngoscope
  • Laryngoscope Investigative Otolaryngology
  • Privacy Policy
  • Terms of Use
  • Cookies

Wiley

Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1559-4939