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Editor's Correspondence |

Placement of a Lateral Nasal Suspension Suture Via an External Rhinoplasty Approach

Scott B. Roofe, MD; Sam P. Most, MD
Arch Facial Plast Surg. 2007;9(3):214-216. doi:10.1001/archfaci.9.3.214.
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Multiple surgical methods to improve external nasal valve collapse have been described.1-3 Some techniques, such as alar batten grafts, have resulted in varying and sometimes unreliable degrees of improvement with potentially undesirable nasal widening. Likewise, overlay cartilaginous grafts may contribute to significant changes in cosmetic appearance. One recently described technique for nasal valve collapse that avoids these concerns is the use of lateral suspension.4-5 However, this technique has been described as an approach that requires external incisions at the alar-facial junction or on the cheek near the infraorbital rim, or through a transconjunctival approach. Herein, we describe placement of the lateral suspension suture through an external approach as an adjunct to functional nasal surgery, avoiding facial incisions and providing superior exposure for placement. Improved functional outcomes are also measured.

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Figure 3.

A patient who presented with cosmetic and nasal airway concerns. She was noted to have dynamic external nasal valve collapse. A, Preoperative view. B, Two-month postoperative result following external nasal valve suspension with septoplasty, turbinate reduction, and cosmetic external rhinoplasty with dome suturing.

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Figure 2.

Diagram showing proper positioning of the bone-anchored suspension suture. The suture is anchored near the medial infraorbital rim and attached to the area of maximal nasal valve collapse on the upper and lower lateral cartilages.

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Figure 1.

Demonstration of technique of lateral suspension suture using a Mitek Bone Anchor Suspension system (Depuy Mitek, Raynham, Mass). A, Placement of the drill hole near the medial infraorbital rim. B, Setting of the anchor system. C, Withdrawal of the device. D, Placement of sutures in the area of the nasal valve.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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