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Instructor: So a dorsal hump and a tip that's a little [inaudible 00:00:07] and then this is a projected after using a united computer imaging. It sort of have a nice, straight dorsum. A slight different -- a day after before you've even go under surgery.
Instructor: Here we've marked the dorsal hump reduction. Here is the line for the micro osteotomy. It's a very small osteotom. Here, we've marked an area that's weak and we're gonna add a little bit of cartilage there. And she's gonna get a columella structure support at the tip as well. And if we see her from the side view-let's see from the side now-you can drop your hand down so you can see the hump. You can see there's this dorsal hump and the width here which we're gonna narrow. And all these will be done through the nostrils.
Instructor: There's the injection. We're just numbing it up. It's just gonna numb it up and be comfortable for it. But more importantly, it's actually gonna provide homeostacis so she doesn't bleed. Same thing on this side. Yup. Can you see that over there? This side where it narrows? This is right where the inter-cartilaging incision is. And here's your septum.
Instructor: So we're popping the turban out of the way. It goes in here. And just quenches the other way so she'll be able to breathe better. Do the same thing on this side. Now it's a wide open space as far as the turban is concerned. The septum is deviated a little. We'll work on the septum. Double chrome wide please. We're gonna -- narrow, double or single. Browns [inaudible 00:02:24]. So we're gonna make an incision. We're gonna make an incision right where the edge of the septum is. The other, Iris?
Iris: I think you wanted from this angle.
Instructor: Right there, here's actually we're stirring right at the septum. [inaudible 00:03:05] please? And then [inaudible 00:03:09]. I use a dental instrument to get into the septum. And very quickly we get into the right plane. We take those off. Now that you're on the right plane, the rest of it can be done with this suction tip. Blunt elevation. Very quickly. Septum is very deviated, but you'll just have to take my word for it as I'm seeing here. So the whole [inaudible 00:04:13] is elevated that bluntly. And the semiculla. A little bucket of saline waiting for me.
Male Voice: [inaudible 00:04:40]
Instructor: Right.
Male Voice: [inaudible 00:04:43]
Instructor: Don't worry. Yeah, I've got three tomorrow. This is her septal cartilage that we've taken off and just let the septum swing in. After the septoplasty, what I do is we separated the lining from the septum. And you wanna suit your back together.
Male Voice: Everything.
Instructor: [inaudible 00:05:20]
Instructor: Here we've marked the dorsal hump reduction. Here is the line for the micro osteotomy. It's a very small osteotom. Here, we've marked an area that's weak and we're gonna add a little bit of cartilage there. And she's gonna get a columella structure support at the tip as well. And if we see her from the side view-let's see from the side now-you can drop your hand down so you can see the hump. You can see there's this dorsal hump and the width here which we're gonna narrow. And all these will be done through the nostrils.
Instructor: There's the injection. We're just numbing it up. It's just gonna numb it up and be comfortable for it. But more importantly, it's actually gonna provide homeostacis so she doesn't bleed. Same thing on this side. Yup. Can you see that over there? This side where it narrows? This is right where the inter-cartilaging incision is. And here's your septum.
Instructor: So we're popping the turban out of the way. It goes in here. And just quenches the other way so she'll be able to breathe better. Do the same thing on this side. Now it's a wide open space as far as the turban is concerned. The septum is deviated a little. We'll work on the septum. Double chrome wide please. We're gonna -- narrow, double or single. Browns [inaudible 00:02:24]. So we're gonna make an incision. We're gonna make an incision right where the edge of the septum is. The other, Iris?
Iris: I think you wanted from this angle.
Instructor: Right there, here's actually we're stirring right at the septum. [inaudible 00:03:05] please? And then [inaudible 00:03:09]. I use a dental instrument to get into the septum. And very quickly we get into the right plane. We take those off. Now that you're on the right plane, the rest of it can be done with this suction tip. Blunt elevation. Very quickly. Septum is very deviated, but you'll just have to take my word for it as I'm seeing here. So the whole [inaudible 00:04:13] is elevated that bluntly. And the semiculla. A little bucket of saline waiting for me.
Male Voice: [inaudible 00:04:40]
Instructor: Right.
Male Voice: [inaudible 00:04:43]
Instructor: Don't worry. Yeah, I've got three tomorrow. This is her septal cartilage that we've taken off and just let the septum swing in. After the septoplasty, what I do is we separated the lining from the septum. And you wanna suit your back together.
Male Voice: Everything.
Instructor: [inaudible 00:05:20]
Closed Septoplasty and Rhinoplasty (Part 1)
Dr. Shervin Naderi undertakes a dorsal hump reduction and septoplasty on a patient who requires extra support at the tip of the nose as well as filler in a particularly weak portion above the right nostril.
