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Chapter-30 Modification of the Bony Nasal Vault

BOOK TITLE: Sataloff's Comprehensive Textbook of Otolaryngology: Head & Neck Surgery (Facial Plastic and Reconstructive Surgery) - Volume 3

Author
1. Sclafani Anthony P
2. Cabin Jonathan A
ISBN
9789351524595
DOI
10.5005/jp/books/12699_31
Edition
1/e
Publishing Year
2016
Pages
26
Author Affiliations
1. The New York Eye and Ear Infirmary; New York Medical College, Valhalla, Center for Facial Plastic Surgery, Chappaqua, New York, USA, New York Eye and Ear Infirmary at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York, USA, Center for Facial Plastic Surgery, Chappaqua, New York, USA
2. New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA
Chapter keywords
bony nasal vault, nasal dorsum, dorsal hump, open roof deformity, bony pyramid, dorsal septum, nasion, nasal bones, maxilla, dorsal width, dorsal concavity, dorsal modification, nasal mucous membranes, bony resection, bony rasping, cartilaginous resection, hump reduction

Abstract

This chapter discusses modification of the bony nasal vault, where surgical alteration of the nasal dorsum is employed to correct dorsal hump, deviation, narrowing, open roof deformity, or focal abnormalities. The nasal dorsum is composed of the bony pyramid and dorsal septum with bilateral upper lateral cartilages, forming the upper-third and middle-third of the nose, respectively. The bony vault can be visualized as a truncated pyramid created by the nasion, nasal bones, and frontal processes of the maxilla. The dorsal width is the horizontal measurement of the nasal bones prior to curving downward toward the maxilla, where the ventral width is the distance between of the nasal bones as they meet the frontal process of the maxilla. A dorsal concavity conveys a more feminine appearance and should be avoided in men. Prior to dorsal modification, topical decongestants should be applied to the nasal mucous membranes, and vasoconstrictor or anesthetic preparations injected into areas of intended manipulation.

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