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Incision of Rhinoplasty
Present by R2溫羽軒
2004/08/26
Incision of rhinoplasty
Incisions:
1. Transcartilaginous
2. Intercartilaginous
3. Marginal
Approaches:
1. Delivery
2. Cartilage splitting
3. Retrograde
4. Open
Transfixion/Hemitransfixion
In the membranous septum between the
caudal border of septum cartilage and
columella
Just caudal to septum
Follows medial crura to flared ends
Extend to floor for tip projection access
Hemi- is unilateral only
Avoids disruption of tip support
Poorer access, Asymmetric healing
Intercartilaginous Incision
Access to the tip and mid-nose
Incision intranasal, between the
ULC/LLC
Begin medially as transfixion extension
Approximately 2mm caudal and parallel
to limen vestibuli until it’s lateral end
May cause nasal obstruction
Intracartilaginous incision
Access to the tip and mid-nose
Starting from anterior end of the transfixion
incision
Parallel to the rim of cartilage
Determined by the width of caudal end of LLC
one desired to leave
Can be made through vestibular skin and
cartilage or skin only
Prevent nasal obstruction
Marginal incision
Through the vestibular skin along the caudal borders
of LLC
From LLC lateral end to columellar-lobular junction
Endonasal approach
Combined with intercartilaginous incision to create
bipedicled flap of cartilage and
mucoperichondrium
Always used in external approach
In continuity with the transfixion incision (stop at
flare end of LLC)
Transcolumellar incision
External approach
Crosses columella just above flared ends of
the medial crura
If too close to the lip, “dip” deformity
No cartilage support to counteract tension
generated by the healing skin
Stair-step incision
Incision of rhinoplasty