Faults and risks in rhinoplasty
Kastenbauer, E.R.
Laryngologie Rhinologie Otologie 55(4): 269-278
1976
ISSN/ISBN: 0340-1588 PMID: 134214 Document Number: 96463
Because obstruction of nasal breathing accompanies a large proportion of the noses which appear to require correction externally, internal and external correction of the nose must always be carried out at the same time. Corrective rhinoplasties are not rarely connected with a certain risk because of a false estimation of the patient's psychic situation and too high expectations concerning the postoperative result. The various problems of the corrective procedure for crooked nose and saddle nose are described as well as the possibilities of using cartilaginous and bony transplants or Silastic implants. The use of histoacryl tissue glue to stick cartilage together in the reconstruction of a saddle nose can only be recommended with great reservations. The method carries a risk of persistent graft damage as a result of exothermic polymerisation processes and various end and split products of histoacryl can cause a long term inflammation and partial necrosis of the strut. The use of Cialitstored homologous cartilage can be recommended. However, in several cases (about 5%) a certain kind of inflammation around the homologous transplants could be observed, perhaps as a consequence of an immunological reaction or as a reaction against the mercury salt in the Cialit solution. The experiences with Silastic implants were very disappointing. In corrective rhinoplasties in childhood the anatomical and functional characteristics of the still developing midface must be taken into consideration. In adults, both esthetic and functional aspects must be borne in mind. The medico-legal situation and the importance of the preoperative informed consent of the patient are discussed.