Thursday, August 18, 2016

COSMETIC RHINOPLASTY

Cosmetic Rhinoplasty
Objective
Correction of nasal deformities such as:
•   hump nose 
•   deviated nose 
•   long nose, etc. 
Position
Supine, head extended, pillow under shoulders, ring under the head, head end of table elevated to 30°.
Anesthesia
•   General or local.
Procedure
1.  Pack nose with xylocaine 2% with Adrenalin 1 in 100000.
2.  Infiltrate with xylocaine 1% with adrenaline 1 in 100,000.
3.  Incisions and exposure of nasal frame work.
4.  Excision of the hump.
5.  Lateral nasal osteotomies.
6.  Shaping of nasal tip cartilages.
7.  Closure.
8.  Taping of nasal dorsum.
9.  Application of nasal splint.
Instruments
•   Limited plastic procedure set 
•   Rhinoplasty set consisting of nasal speculums 2 
•   Double pronged hook (Kilner) 
•   Periosteum elevator (Joseph) (Fig. 18.21) 
•   Nasal retractor (Aufricht) (Fig. 18.22) 
•   Nasal chisel (McIndoe) (Fig. 18.23) 
•   Double guided nasal osteotome (Cinelli) (Fig. 18.24)
•   Osteotome 2 mm 
•   Dorsal scissors (Cottle) (Fig. 18.25) 
•   Cartilage scissors 
•   Nasal rasp 
•   Glabellar rasp 
•   Sutures:
     a.  5‘0’ Chromic catgut on curved cutting needle 
     b.  5‘0’ Vicryl or PDS in curved round body needle 
     c.  6‘0’ Prolene on curved cutting needle.
Dressing
•   Vaseline gauze 
•   Micropore tape cut into strips 1/4" wide and 4" long
•   Gypsona/Velroc/Aluminum sheet for nasal splint.

Any questions be sent to drmmkapur@gmail.com
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