Restorative rhinoplasty in the aging patient
Identifieur interne : 006B07 ( Main/Exploration ); précédent : 006B06; suivant : 006B08Restorative rhinoplasty in the aging patient
Auteurs : C. Spencer Cochran [États-Unis] ; Yadranko Ducic ; Robert J. DefattaSource :
- The Laryngoscope [ 0023-852X ] ; 2007.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme, Personne âgée.
English descriptors
- KwdEn :
Abstract
Objective: The objective of this study is to review our favorable experience in performing rhinoplasty in aging patients. Methods: All patients aged 65 years or greater who underwent rhinoplasty, either esthetic or functional, by the senior author (Y.D.) from August 1997 to July 2005 with a minimum follow up of 1 year were retrospectively reviewed. Results: A total of 51 patients met the inclusion criteria and had complete records available for review. The average age was 69.5 years (range, 65-82 years) with 24 female and 27 male patients. All but two patients underwent open rhinoplasty. Eighteen procedures represented secondary rhinoplasties. Seven patients required auricular cartilage grafts, and 11 patients required costal cartilage grafts. One costal cartilage graft was aborted as a result of excessive calcification. All patients underwent columellar strut placement, 92% underwent internal valve grafts, and 80.4% underwent grafting of the external nasal valves. Nasal osteotomies were performed in only 23.5% of patients, all with the percutaneous technique. Revision surgery was necessary in only three (5.8%) patients, all of whom required grafting of the external valve (not performed primarily). In each of these cases, no significant external valve collapse was noted preoperatively. Premaxillary augmentation with diced or crushed cartilage grafts was performed in 81.8% (n = 18) of patients with an edentulous maxillary arch. Conclusions: Aging patients present unique technical challenges in rhinoplasty that warrant a comprehensive approach to restore internal and external valve competency and tip support. Consideration of prophylactic external valve grafts in addition to the routine use of internal valve grafts and columellar struts may help decrease the need for revision surgery in this patient population. Reasonable functional and esthetic outcomes can be expected in the aging patient.
Affiliations:
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Spencer Cochran</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Otolaryngology-Head & Neck Surgery, University of Texas Southwestern Medical Center at Dallas</s1><s2>Dallas, Texas</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Division of Otolaryngology and Facial Plastic Surgery, John Peter Smith Hospital</s1><s2>Fort Worth, Texas</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Ducic, Yadranko" sort="Ducic, Yadranko" uniqKey="Ducic Y" first="Yadranko" last="Ducic">Yadranko Ducic</name></author><author><name sortKey="Defatta, Robert J" sort="Defatta, Robert J" uniqKey="Defatta R" first="Robert J." last="Defatta">Robert J. Defatta</name></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">07-0250208</idno><date when="2007">2007</date><idno type="stanalyst">PASCAL 07-0250208 INIST</idno><idno type="RBID">Pascal:07-0250208</idno><idno type="wicri:Area/PascalFrancis/Corpus">000436</idno><idno type="wicri:Area/PascalFrancis/Curation">000267</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000396</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000396</idno><idno type="wicri:doubleKey">0023-852X:2007:Spencer Cochran C:restorative:rhinoplasty:in</idno><idno type="wicri:Area/Main/Merge">006C15</idno><idno type="wicri:Area/Main/Curation">006B07</idno><idno type="wicri:Area/Main/Exploration">006B07</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Restorative rhinoplasty in the aging patient</title><author><name sortKey="Spencer Cochran, C" sort="Spencer Cochran, C" uniqKey="Spencer Cochran C" first="C." last="Spencer Cochran">C. Spencer Cochran</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Otolaryngology-Head & Neck Surgery, University of Texas Southwestern Medical Center at Dallas</s1><s2>Dallas, Texas</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Division of Otolaryngology and Facial Plastic Surgery, John Peter Smith Hospital</s1><s2>Fort Worth, Texas</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Ducic, Yadranko" sort="Ducic, Yadranko" uniqKey="Ducic Y" first="Yadranko" last="Ducic">Yadranko Ducic</name></author><author><name sortKey="Defatta, Robert J" sort="Defatta, Robert J" uniqKey="Defatta R" first="Robert J." last="Defatta">Robert J. Defatta</name></author></analytic><series><title level="j" type="main">The Laryngoscope</title><title level="j" type="abbreviated">Laryngoscope</title><idno type="ISSN">0023-852X</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">The Laryngoscope</title><title level="j" type="abbreviated">Laryngoscope</title><idno type="ISSN">0023-852X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Ageing</term><term>Airways obstruction</term><term>ENT</term><term>Elderly</term><term>Human</term><term>Nose</term><term>Plastic surgery</term><term>Plasty</term><term>Rhinoplasty</term><term>Stomatology</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Obstruction voies respiratoires</term><term>Plastie</term><term>Chirurgie plastique</term><term>Nez</term><term>Stomatologie</term><term>Vieillissement</term><term>Homme</term><term>Personne âgée</term><term>ORL</term><term>Traitement</term><term>Rhinoplastie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term><term>Personne âgée</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: The objective of this study is to review our favorable experience in performing rhinoplasty in aging patients. Methods: All patients aged 65 years or greater who underwent rhinoplasty, either esthetic or functional, by the senior author (Y.D.) from August 1997 to July 2005 with a minimum follow up of 1 year were retrospectively reviewed. Results: A total of 51 patients met the inclusion criteria and had complete records available for review. The average age was 69.5 years (range, 65-82 years) with 24 female and 27 male patients. All but two patients underwent open rhinoplasty. Eighteen procedures represented secondary rhinoplasties. Seven patients required auricular cartilage grafts, and 11 patients required costal cartilage grafts. One costal cartilage graft was aborted as a result of excessive calcification. All patients underwent columellar strut placement, 92% underwent internal valve grafts, and 80.4% underwent grafting of the external nasal valves. Nasal osteotomies were performed in only 23.5% of patients, all with the percutaneous technique. Revision surgery was necessary in only three (5.8%) patients, all of whom required grafting of the external valve (not performed primarily). In each of these cases, no significant external valve collapse was noted preoperatively. Premaxillary augmentation with diced or crushed cartilage grafts was performed in 81.8% (n = 18) of patients with an edentulous maxillary arch. Conclusions: Aging patients present unique technical challenges in rhinoplasty that warrant a comprehensive approach to restore internal and external valve competency and tip support. Consideration of prophylactic external valve grafts in addition to the routine use of internal valve grafts and columellar struts may help decrease the need for revision surgery in this patient population. Reasonable functional and esthetic outcomes can be expected in the aging patient.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Texas</li></region></list><tree><noCountry><name sortKey="Defatta, Robert J" sort="Defatta, Robert J" uniqKey="Defatta R" first="Robert J." last="Defatta">Robert J. Defatta</name><name sortKey="Ducic, Yadranko" sort="Ducic, Yadranko" uniqKey="Ducic Y" first="Yadranko" last="Ducic">Yadranko Ducic</name></noCountry><country name="États-Unis"><region name="Texas"><name sortKey="Spencer Cochran, C" sort="Spencer Cochran, C" uniqKey="Spencer Cochran C" first="C." last="Spencer Cochran">C. Spencer Cochran</name></region><name sortKey="Spencer Cochran, C" sort="Spencer Cochran, C" uniqKey="Spencer Cochran C" first="C." last="Spencer Cochran">C. Spencer Cochran</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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