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Facial Plast Surg 2022; 38(01): 007-012
DOI: 10.1055/s-0041-1730388
Original Article

Treatment of the Middle Third and Septal Deformity: A Trizonal Approach

Eliezer C. Kinberg 
1   Department of Otolaryngology-Head and Neck Surgery, Mount Sinai School of Medicine, New York, New York
,
William Lawson
1   Department of Otolaryngology-Head and Neck Surgery, Mount Sinai School of Medicine, New York, New York
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Erratum: Treatment of the Middle Third and Septal Deformity: A Trizonal ApproachFacial Plast Surg 2022; 38(01): e1-e1
DOI: 10.1055/s-0042-1757691

Abstract

Genetic, developmental, traumatic factors can produce a wide variety of nasal septal deformities in caudal–cephalic/dorsal–maxillary planes alone or in combination. These can be corrected by an endonasal approach through a transfixion incision by resecting, transposing, or utilizing principles of cartilage biomechanics. The authors are proposing a “Rosetta Stone” based on a trizonal analysis of the deviated nose that considers the contribution of each region to the deformity. Clinical assessment of the deviated nose should be segmental as well as global. Surgical correlation of the nasal bones, perpendicular, and quadrilateral plates, lateral cartilages, and turbinates may be necessary to achieve a satisfactory cosmetic and functional results.

Keywords

rhinoplasty - functional rhinoplasty - septal deviation


Publication History

Article published online:
05 July 2021

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  • References

  • 1 Lawson W, Reino A. Correcting functional problems. Facial Plast Surg 1994; 2 (04) 501-520
    PubMedGoogle Scholar
  • 2 Cottle MH, Loring RM. Corrective surgery of the external nasal pyramid and the nasal septum for restoration of normal physiology. Eye Ear Nose Throat Mon 1947; 26 (04) 207-212
    PubMedGoogle Scholar
  • 3 McCollough EG, Mangat D. Systematic approach to correction of the nasal tip in rhinoplasty. Arch Otolaryngol 1981; 107 (01) 12-16
    CrossrefPubMedGoogle Scholar
  • 4 Westreich RW, Lawson W. The tripod theory of nasal tip support revisited: the cantilevered spring model. Arch Facial Plast Surg 2008; 10 (03) 170-179
    CrossrefPubMedGoogle Scholar
  • 5 Rhee JS, Arganbright JM, McMullin BT, Hannley M. Evidence supporting functional rhinoplasty or nasal valve repair: a 25-year systematic review. Otolaryngol Head Neck Surg 2008; 139 (01) 10-20
    CrossrefPubMedGoogle Scholar
  • 6 Cottle MH. Concepts of nasal physiology as related to corrective nasal surgery. Arch Otolaryngol 1960; 72 (01) 11-20
    CrossrefPubMedGoogle Scholar
  • 7 Ammar SM, Westreich RW, Lawson W. Fan septoplasty for correction of the internally and externally deviated nose. Arch Facial Plast Surg 2006; 8 (03) 213-216
    CrossrefPubMedGoogle Scholar
  • 8 Murakami WT, Wong LW, Davidson TM. Applications of the biomechanical behavior of cartilage to nasal septoplastic surgery. Laryngoscope 1982; 92 (03) 300-309
    CrossrefPubMedGoogle Scholar
  • 9 Goldman IB. New technique in surgery of the deviated nasal septum. AMA Arch Otolaryngol 1956; 64 (03) 183-189
    CrossrefPubMedGoogle Scholar
  • 10 Lawson W, Westreich R. Correction of caudal deflections of the nasal septum with a modified Goldman septoplasty technique: how we do it. Ear Nose Throat J 2007; 86 (10) 617-620
    CrossrefPubMedGoogle Scholar