Functional septorhinoplasty

Functional Septorhinoplasty functional rhinoplasty nz

Functional Septorhinoplasty is an operation undertaken to improve the nasal airway in people who are suffering from nasal obstruction. Broadly speaking, there are two groups of people who suffer from this condition. Those that develop nasal obstruction later life (acquired nasal obstruction), most commonly a result of trauma. Some of the features of ageing also bring about nasal obstruction. The other large group of people are born with nasal obstruction (termed a congenital nasal obstruction) and one of these causes can be the shape of the nose. This most commonly occurs in those with a Caucasian-shaped nose. Other racial groups have rounder nostrils, compared to the relatively narrow cleft of the Caucasian nose which is more predisposed to nasal obstruction.

If the nose is deemed to be too tall or has a hump, this is removed with sharp instruments. If this is simply left as is, it results in what is termed the "open book deformity" (a wide nasal dorsum with three prominences from each nasal bone and the septum). To "close the book" the nasal bones need to be cut to enable this to be achieved. This is demonstrated in the diagrams below.

Frequently, there is insufficient cartilage within the septum to create the above-mentioned battens, struts or spreader grafts. In that case, cartilage can be harvested from the flat portion of the ear against the head called the conchal bowl. Less commonly, cartilage may need to be harvested from the ribs.


The procedure

Surgery takes place under general anaesthetic. A gullwing incision is undertaken over the columella (see diagram below). All other incisions are inside the nose.

If the nose is deemed to be too tall or has a hump, this is removed with sharp instruments. If this is simply left as it is, this results in what is termed the "open book deformity" - a wide nasal dorsum with three prominences from each nasal bone and the septum. To "close the book" the nasal bones need to be cut (termed an osteotomy) to enable this to be achieved. This is demonstrated in the diagrams below.

Brandon Hitchcock Functional Septorhinoplasty

Frequently, there is insufficient cartilage within the septum to create the above-mentioned battens, struts or spreader grafts. In that case, cartilage can be harvested from the flat portion of the ear against the head called the conchal bowl. Less commonly, cartilage may need to be harvested from the ribs.

At the conclusion of surgery, the columella is sutured with non-dissolving stitches and all incisions inside the nose are closed with dissolving stitches. Paper tape is applied across the top of the nose to control swelling and if work has been undertaken on the bones of the nose, a plastic splint is applied over the top of the nose.


Post surgery procedure

Usually, the nose feels very clear after surgery but may quickly become blocked from the surgical swelling and bleeding if a septorhinoplasty has been undertaken with endoscopic sinus surgery. This is usually for a maximum of 48 hours and slowly improves thereafter. If the nasal bones are operated upon, swelling and bruising is the usual outcome, but this usually settles in 10-14 days.


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