I have been referred and went to see a head and neck doctor with ent, they said my pain was caused by congestion and that I should use neil med nasal rinse and take intermittent steroid sprays and wear nose strips at night, I would like revision rhinoplasty to add support to my nose, I , but the consultaion with the head and neck doctor, they said I had collapsed nostrils during inhalation and weak alar cartilage and a mild deformity. Can they do anything about this,
Answer: Collapsed nostrils I am going to assume that the nasal septum was straightened and the inferior turbinates reduced at the first surgery. If the nostrils are collapsing then there may be insufficient support from the lateral crura of the lower lateral cartilages. The first step I take is to see if the airway improves by manually pulling the cheek laterally where it attaches to the nostril and having the patient estimate the degree of benefit. If the airway improves then I decongest the turbinates with Afrin, wait about 10 minutes, and repeat the maneuver again. If there is no or little improvement it tells me that the turbinate, not the nostril is the cause. If there is still substantial benefit with the maneuver after Afrin then I use a small wire loop to pull laterally areas of the nostril to see where the areas of obstruction are. Once I know that then I can plan where best to apply cartilage grafts (spreader or alar batten, or both; flaring sutures). I prefer to use ear cartilage to take advantage of its natural curvature and flexibility
Helpful 1 person found this helpful
Answer: Collapsed nostrils I am going to assume that the nasal septum was straightened and the inferior turbinates reduced at the first surgery. If the nostrils are collapsing then there may be insufficient support from the lateral crura of the lower lateral cartilages. The first step I take is to see if the airway improves by manually pulling the cheek laterally where it attaches to the nostril and having the patient estimate the degree of benefit. If the airway improves then I decongest the turbinates with Afrin, wait about 10 minutes, and repeat the maneuver again. If there is no or little improvement it tells me that the turbinate, not the nostril is the cause. If there is still substantial benefit with the maneuver after Afrin then I use a small wire loop to pull laterally areas of the nostril to see where the areas of obstruction are. Once I know that then I can plan where best to apply cartilage grafts (spreader or alar batten, or both; flaring sutures). I prefer to use ear cartilage to take advantage of its natural curvature and flexibility
Helpful 1 person found this helpful
