ABSTRACT
Septorhinoplasty in children carries the risk of growth disturbance of the nose and
premaxilla. The open or external approach has the advantage that the cartilaginous
nasal skeleton remains intact. This open approach enables the surgeon to excise dermoid
cysts and to realign lower lateral cartilages (unilateral cleft) without disturbing
the integrity of the cartilaginous skeleton. In our experience, absolute indications
for open rhinoplasty in children include dermoid cyst, cleft lip nose, and septal
abscess. Relative indications include septal deviations causing severe nasal airway
obstruction and or progressive distortion of the nose. In this article, we discuss
the indications, advantages, disadvantages, and operative technique of open rhinoplasty
in children. Our indications for open rhinoplasty in children and some selected cases
are illustrated.
KEYWORDS
External approach - open approach - rhinoplasty - children
REFERENCES
1
Snell D.
History of external rhinoplasty.
J Otolaryngol.
1978;
7
1
2
Rethi A.
Operation to shorten an excessively long nose.
Rev Chir Plast.
1934;
2
85
3
Sercer A.
Dekortication der Nose.
Chir Maxillofac Plast (Zagreb).
1958;
1
49
4
Padovan I F.
External approach in rhinoplasty (decortication).
Symp ORL.
1966;
4
354-360
5
Goodman W S, Charbonneau P A.
External approach to rhinoplasty.
Laryngoscope.
1974;
84
2195-2201
6
Hage J.
Surgical approach to the external and internal nose: with a supplementary report on
two cases of nasal glioma.
Br J Plast Surg.
1960;
12
327-339
7
Freer O T.
The correction of deflections of the nasal septum with a minimum of traumatism.
JAMA.
1902;
38
636-642
8
Killian G.
The submucous window resection of the nasal septum.
Ann Otolaryngol.
1905;
14
363-373
9
Cottle M H, Loring R M.
Surgery of the nasal septum: new operative procedures and indications.
Amm Otol Rhinol Laryng.
1948;
57
705-713
10
Goldman I B.
New technique in surgery of the deviated nasal septum.
Arch Otolaryng.
1956;
64
183-189
11
Pirsig W.
Septal plasty in children: influence on nasal growth.
Rhinology.
1977;
15
193-204
12
Huizing E H.
Septum surgery in children: indications, surgical technique and long term results.
Rhinology.
1979;
17
91-100
13
Nolst trenite G J, Verwoerd C DA, Verwoerd-Verhoef H L.
Reimplantation of autologous septal cartilage in the growing nasal septum. I. The
influence of resection and reimplantation of septal cartilage upon nasal growth: an
experimental study in growing rabbits.
Rhinology.
1987;
25
225-236
14
Crysdale W S, Tatham B.
External septo-rhinoplasty in children.
Laryngoscope.
1985;
95
12-16
15
Jugo S B.
Total septal reconstruction through decortication (external) approach in children.
Arch Otolaryngol Head Neck Surg.
1987;
113
173-178
16
Triglia J M, Cannoni M, Pech A.
Septo-rhinoplasty in children: outcome and effect on growth of septal excision and
reimplantation.
J Otolaryngol.
1990;
19
274-278
17
El-Hakim H, Crysdale W, Abdollel M, Farkas L G.
A study of anthropometric measures before and after external septoplasty in children.
Arch Otolaryngol Head Neck Surg.
2001;
127
1362-1366
18 Verwoerd C DA, Verwoerd-Verhoef H L.
Rhinosurgery in children: developmental and surgical aspects . In: Nolst Trenite GJ Rhinoplasty, a Practical Guide to Functional and Aesthetic
Surgery of the Nose. The Hague; Kugler Publications 2005: 201-208
19 Johnson C M, Toriumi D M. Open Structure Rhinoplasty. Philadelphia; WB Saunders
1990: 47-98
20 Nolst Trenite G J, Vinayak B C.
External rhinoplasty: the benefits and pitfalls . In: Nolst Trenite GJ Rhinoplasty, a Practical Guide to Functional and Aesthetic
Surgery of the Nose. The Hague; Kugler Publications 2005: 125-141
21
Goodman W S, Charles D A.
Why external rhinoplasty?.
J Otolaryngol.
1978;
7
6-8
22
Adamson P A, Smith O, Tropper G J.
Incision and scar analysis in open (external) rhinoplasty.
Arch Otolaryngol Head Neck Surg.
1990;
116
671-675
23
Denoyelle F, Ducroz V, Roger G, Garabedian E N.
Nasal dermoid cysts in children.
Laryngoscope.
1997;
107
795-800
24
Dispenza C, Saraniti C, Dispenza F, Caramanna C, Salzano F A.
Management of nasal septal abscess in childhood: our experience.
Int J Pediatr Otorhinolaryngol.
2004;
68
1417-1421
25
Boenisch M, Hajas T, Nolst Trenite G J.
Influence of polydioxanone foil on growing septal cartilage after surgery in an animal
model.
Arch Facial Plast Surg.
2003;
5
316-319
26
Schrader M, Jahnke K.
Tragal cartilage in the primary reconstruction of defects resulting from a nasal septal
abscess.
Clin Otolaryngol Allied Sci.
1995;
20
527-529
27 Nolst Trenite G J.
Secondary surgery of the cleft-lip nose . In: Nolst Trenite GJ Rhinoplasty, a Practical Guide to Functional and Aesthetic
Surgery of the Nose. The Hague; Kugler Publications 2005: 149-165
Professor Gilbert J Nolst TrenitéM.D. Ph.D.
Department of Otorhinolaryngology & Facial Plastic Surgery, Academic Medical Center
of the University of Amsterdam
A2-232, PO Box 22660, 1100 DD Amsterdam, The Netherlands