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Saddle Nose and the L-Shaped Graft

Saddle Nose and the L-Shaped Graft Abstract The contemporary teaching that the correction of a saddle nose lacking tip support necessitates the insertion of an L-shaped (hinged) graft is based on the premise that the lobule is supported mainly by the septum.1,3,6,7 The purpose of this paper is to present some evidence to show that this teaching requires revision and that the L-shaped graft has no place in rhinoplastic surgery. Perhaps we can bring our facts into better focus by giving the background of the L-shaped graft, its disadvantages, and the reason why we have abandoned its use for the past 20 years. History The use of the L-shaped graft began in the latter half of the 1800's at a time when rhinoplastic surgeons were beset by many problems, one of which was how to produce a gradually increasing nasal profile projection. Credit for the solution of this problem must be given to von Hacker8 References 1. Brown, J. B.: Summary of Development in Plastic Surgery, from 1905-1955 , Surg. Gynec. & Obst. 101:209, 1955. 2. Fomon, S.: The Treatment of Old Unreduced Nasal Fractures , Ann. Surg. 104:107, 1936. 3. Fomon, S.: Surgery of Injury and Plastic Repair , Baltimore, The Williams & Wilkins Company, 1939. 4. Fomon, S.: Otolaryngologic Plastic Surgery , in Otolaryngology , Vol. 3, Ch. 26, edited by G. M. Coates, H. P. Schenk, and M. V. Miller, Hagerstown, Md., W. F. Prior & Co., 1955. 5. Fomon, S.: Principles and Practice Cosmetic Surgery, Philadelphia, J. B. Lippincott Company, to be published. 6. Gillies, H. D.: Depressed Fracture of the Nasal Arch , Proc. Roy. Soc. Med., Sect. Laryng. 16:6, 1922. 7. Gillies, H. D., and Millard, D. R., Jr.: The Principles and Art of Plastic Surgery , Boston, Little, Brown & Company, 1957. 8. von Hacker, V.: Über die Verwendung eines eine Periost-Knochenspange enthaltenden Stirnlappens zur Rhinoplastik , Wien. klin. Wchnschr. 1:36, 65, 1888. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Otolaryngology American Medical Association

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References (7)

Publisher
American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0096-6894
DOI
10.1001/archotol.1960.03770060044006
Publisher site
See Article on Publisher Site

Abstract

Abstract The contemporary teaching that the correction of a saddle nose lacking tip support necessitates the insertion of an L-shaped (hinged) graft is based on the premise that the lobule is supported mainly by the septum.1,3,6,7 The purpose of this paper is to present some evidence to show that this teaching requires revision and that the L-shaped graft has no place in rhinoplastic surgery. Perhaps we can bring our facts into better focus by giving the background of the L-shaped graft, its disadvantages, and the reason why we have abandoned its use for the past 20 years. History The use of the L-shaped graft began in the latter half of the 1800's at a time when rhinoplastic surgeons were beset by many problems, one of which was how to produce a gradually increasing nasal profile projection. Credit for the solution of this problem must be given to von Hacker8 References 1. Brown, J. B.: Summary of Development in Plastic Surgery, from 1905-1955 , Surg. Gynec. & Obst. 101:209, 1955. 2. Fomon, S.: The Treatment of Old Unreduced Nasal Fractures , Ann. Surg. 104:107, 1936. 3. Fomon, S.: Surgery of Injury and Plastic Repair , Baltimore, The Williams & Wilkins Company, 1939. 4. Fomon, S.: Otolaryngologic Plastic Surgery , in Otolaryngology , Vol. 3, Ch. 26, edited by G. M. Coates, H. P. Schenk, and M. V. Miller, Hagerstown, Md., W. F. Prior & Co., 1955. 5. Fomon, S.: Principles and Practice Cosmetic Surgery, Philadelphia, J. B. Lippincott Company, to be published. 6. Gillies, H. D.: Depressed Fracture of the Nasal Arch , Proc. Roy. Soc. Med., Sect. Laryng. 16:6, 1922. 7. Gillies, H. D., and Millard, D. R., Jr.: The Principles and Art of Plastic Surgery , Boston, Little, Brown & Company, 1957. 8. von Hacker, V.: Über die Verwendung eines eine Periost-Knochenspange enthaltenden Stirnlappens zur Rhinoplastik , Wien. klin. Wchnschr. 1:36, 65, 1888.

Journal

A.M.A. Archives of OtolaryngologyAmerican Medical Association

Published: Jun 1, 1960

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