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Physiologic Concerns During Rhinoplasty

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Nasal Physiology and Pathophysiology of Nasal Disorders
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Abstract

The internal and external nasal valves are key to a patient’s breathing function, playing a critical role in rhinoplasty so an esthetically pleasing external nose can result without disturbing nasal breathing. The valve physiology is reviewed and a new classification of internal nasal valve pathology is presented so surgeons can avoid postoperative breathing complications after rhinoplasty.

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References

  • Adamson JE. Constriction of the internal nasal valve in rhinoplasty. Treatment and prevention. Ann Plast Surg. 1987;18:114.

    Article  PubMed  CAS  Google Scholar 

  • Adamson PA, Smith O, Cole P. The effects of cosmetic rhinoplasty on nasal patency. Laryngoscope. 1990;100:357.

    Article  PubMed  CAS  Google Scholar 

  • Aksoy A, Veyseller B, Yildirim YS, et al. Role of nasal muscles in nasal valve collapse. Otolaryngol Head Neck Surg. 2010;142:365.

    Article  PubMed  Google Scholar 

  • Anderson JR. A new approach to rhinoplasty. Trans Am Acad Opthalmol Otolaryngol. 1966;70:183.

    CAS  Google Scholar 

  • Araco A, Gravante G, Gentile P, et al. Iatrogenic collapse of the nasal valve in aesthetic rhinoplasty. Scand J Plast Reconstr Hand Surg. 2007;41:293.

    Article  Google Scholar 

  • Arbour P, Kern EB. Paradoxical nasal obstruction. Can J Otolaryngol. 1975;4:333.

    PubMed  CAS  Google Scholar 

  • Barelli PA, Kern EB, Loch WEE, et al. Rhinology. The collected writings of Maurice H. Cottle, M.D. Kansas City: American Rhinologic Society; 1987.

    Google Scholar 

  • Barrs DM, Kern EB. Acute nasal trauma: emergency room care of 250 patients. J Fam Pract. 1980;10:225.

    PubMed  CAS  Google Scholar 

  • Becker SS, Dobratz EJ, Stowell N, et al. Revision septoplasty: review of sources of persistent nasal obstruction. Am J Rhinol. 2008;22:440.

    Article  PubMed  Google Scholar 

  • Beekhuis GJ. Nasal obstruction after rhinoplasty: etiology, and techniques for correction. Laryngoscope. 1976;86:540.

    Article  PubMed  CAS  Google Scholar 

  • Berry RB. Nasal resistance before and after rhinoplasty. Br J Plast Surg. 1981;34:105.

    Article  PubMed  CAS  Google Scholar 

  • Bottini DJ, Gentile P, Arpino A, et al. Reconstruction of the nasal valve. J Craniofac Surg. 2007;18:516.

    Article  PubMed  Google Scholar 

  • Breadon GB, Kern EB, Neel HBIIII. Autografts of uncrushed and crushed bone and cartilage: experimental observations and clinical implications. Arch Otolaryngol. 1979;105:75.

    Article  PubMed  CAS  Google Scholar 

  • Bridger GP. Physiology of the nasal valve. Arch Otolaryngol. 1970;92:543.

    Article  PubMed  CAS  Google Scholar 

  • Bridger GP, Proctor DF. Maximum nasal inspiratory flow and nasal resistance. Ann Otol Rhinol Laryngol. 1970;79:481.

    PubMed  CAS  Google Scholar 

  • Broms P. Rhinomanometry: III procedures and criteria for distinction between skeletal stenosis and mucosal swelling. Acta Otolaryngol (Stockh). 1982;94:361.

    Article  CAS  Google Scholar 

  • Bruno JR, Papay FA, Papay FA. Dispelling the propagated myth: a quizzical look at the internal nasal valve (letters and viewpoints). Plast Reconstr Surg. 2005;116:685.

    Article  PubMed  CAS  Google Scholar 

  • Camirand A, Doucet J, Harris J. Nose surgery: how to prevent a middle vault collapse-a review of 50 patients 3 to 21 years after surgery. Plast Reconstr Surg. 2004;114:527.

    Article  PubMed  Google Scholar 

  • Chhabra N, Houser SM. The diagnosis and management of empty nose syndrome. Otolaryngol Clin North Am. 2009;42(2):311.

    Article  PubMed  Google Scholar 

  • Cole P. Biophysics of nasal airflow: a review. Am J Rhinol. 2000;14:245.

    Article  PubMed  CAS  Google Scholar 

  • Cole P. The four components of the nasal valve. Am J Rhinol. 2003;17:107.

    PubMed  Google Scholar 

  • Constantian M. The incompetent external nasal valve: pathophysiology and treatment in primary and secondary rhinoplasty. Plast Reconstr Surg. 1994;93:919.

    Article  PubMed  CAS  Google Scholar 

  • Constantian M, Clardy RB. The relative importance of septal and nasal valvular surgery in correcting airway obstruction in primary and secondary rhinoplasty. Plast Reconstr Surg. 1996;98:38.

    Article  PubMed  CAS  Google Scholar 

  • Corey JP. Acoustic rhinometry: should we be using it? Curr Opin Otolaryngol Head Neck Surg. 2006;14:29.

    Article  PubMed  Google Scholar 

  • Cottle MH, Loring RM, Fischer GG, et al. The “maxilla-premaxilla” approach to extensive nasal septum surgery. Arch Otolaryngol. 1958;68:301.

    Article  CAS  Google Scholar 

  • Courtiss E, Goldwyn R. The effects of nasal surgery on air flow. Plast Reconstr Surg. 1983;7:16.

    Google Scholar 

  • de Wit G, Kapteyn TS, van Bochove WM. Some remarks on the physiology, the anatomy and the radiology of the vestibulum and the isthmus nasi. Int Rhinol. 1965;3:37.

    Google Scholar 

  • Eccles R. Nasal airflow in health and disease. Acta Otolaryngol. 2000;120:580–95.

    Article  PubMed  CAS  Google Scholar 

  • Fischer H, Gubisch W. Nasal valves-Importance and surgical procedures. Facial Plast Surg. 2006;22:266.

    Article  PubMed  CAS  Google Scholar 

  • Goin JG, Goin MK. Changing the body: psychological effects of plastic surgery. Baltimore/London: Williams and Wilkins; 1981.

    Google Scholar 

  • Goode RL. Surgery of the incompetent nasal valve. Laryngoscope. 1985;95:546.

    Article  PubMed  CAS  Google Scholar 

  • Gordon AS, McCaffrey TV, Kern EB, Pallanch JF. Rhinomanometry for preoperative and postoperative assessment of nasal obstruction. Otolaryngol Head Neck Surg. 1989;101:120.

    Google Scholar 

  • Gray VD. Physiologic returning of the upper lateral cartilage. Int Rhinol. 1970;8:56.

    Google Scholar 

  • Grymer FL. Reduction rhinoplasty and nasal patency: change in the cross-sectional area of the nose evaluated by acoustic rhinometry. Laryngoscope. 1995;105:429.

    Article  PubMed  CAS  Google Scholar 

  • Guenthner TA, Sathe AH, Kern EB. The effect of Le Fort I maxillary impaction on nasal airway resistance. Am J Orthod. 1984;85:308.

    Article  PubMed  CAS  Google Scholar 

  • Hage J. Collapsed alae strengthened by conchal cartilage (the butterfly cartilage graft). Br J Plast Surg. 1965;18:92.

    Article  PubMed  CAS  Google Scholar 

  • Haight JSJ, Cole P. The site and function of the nasal valve. Laryngoscope. 1983;93:49.

    Article  PubMed  CAS  Google Scholar 

  • Hasegawa M, Kern EB. The human nasal cycle. Mayo Clin Proc. 1977;52:28.

    PubMed  CAS  Google Scholar 

  • Heinberg CE, Kern EB. The Cottle sign: an aid in the physical diagnosis of nasal airflow disturbances. Rhinology. 1973;11:89.

    Google Scholar 

  • Helal MZ, El-Tarabishi M, Sabry SM, et al. Effects of rhinoplasty on the internal nasal valve: a comparison between internal continuous and external perforating osteotomy. Ann Plast Surg. 2010;64:649.

    PubMed  CAS  Google Scholar 

  • Hellings PW, Nolst Trenite GP. Long-term patient satisfaction after revision rhinoplasty. Laryngoscope. 2007;117:985.

    Article  PubMed  Google Scholar 

  • Hilberg O, Jackson AC, Swift DL, et al. Acoustic rhinometry: evaluation of nasal cavity geometry by acoustic reflections. J Appl Physiol. 1989;66:295.

    PubMed  CAS  Google Scholar 

  • Hinderer KH. Surgery of the valve. Int Rhinol. 1970;8:60.

    Google Scholar 

  • Hinderer KH. Fundamentals of anatomy and surgery of the nose. Birmingham: Aesculapius Publishing Company; 1971.

    Google Scholar 

  • Houser SM. Surgical treatment for empty nose syndrome. Arch Otolaryngol Head Neck Surg. 2007;133:858.

    Article  PubMed  Google Scholar 

  • Huizing EH, de Groot JAM. Functional nasal surgery. Stuttgart/New York: Thieme; 2003.

    Google Scholar 

  • Javanbakht M, Nazari A, Javanbakht A, et al. Body dysmorphic factors and mental health problems in people seeking rhinoplastic surgery. Acta Otorhinolaryngol Ital. 2012;32:37.

    PubMed  CAS  Google Scholar 

  • Jessen MD, Jacobsson S, Malm L. On rhinomanometry in rhinoplasty. Plast Reconstr Surg. 1988;81:506.

    Article  PubMed  CAS  Google Scholar 

  • Kasperbauer JL, Kern EB. Nasal valve physiology: implications in nasal surgery. Otolaryngol Clin North Am. 1987;20(4):699.

    PubMed  CAS  Google Scholar 

  • Kern EB. Use of a questionnaire for patients with nasal symptoms. Rhinology. 1972;10:133.

    Google Scholar 

  • Kern EB. Rhinomanometry. Otolaryngol Clin North Am. 1973;6:863.

    PubMed  CAS  Google Scholar 

  • Kern EB. The nose: structure and function. Postgrad Med. 1975;57:101.

    PubMed  CAS  Google Scholar 

  • Kern EB. Surgery of the nasal valve. Plastic and reconstructive surgery of the face and neck. In: Sisson GA, Tardy ME Jr, editors. Proceedings of the second international symposium, vol. 2. New York: Grune and Stratton; 1977a.

    Google Scholar 

  • Kern EB. Standardization of rhinomanometry. Rhinology. 1977b;15:115.

    PubMed  CAS  Google Scholar 

  • Kern EB. Surgical approaches to abnormalities of the nasal valve. Rhinology. 1978;16:165.

    PubMed  CAS  Google Scholar 

  • Kern EB. Rhinomanometry. In: English GM, editor. Otolaryngology, vol. 2. Hagerstown: Harper and Row Publishers; 1979.

    Google Scholar 

  • Kern EB. Nasal septal reconstruction versus submucous resection. In: Snow JB, editor. Controversy in otolaryngology. Philadelphia: W.B. Saunders; 1980a.

    Google Scholar 

  • Kern EB. “Alar Collapse” – an opinion in the collected letters of the international correspondence society of ophthalmologists and otolaryngologists. Feb 15, 1980b;Series XXV, p. 17.

    Google Scholar 

  • Kern EB. The noncycle nose. Rhinology. 1981;19:59.

    PubMed  CAS  Google Scholar 

  • Kern EB. Applied physiology of the nasal cavities. Rhinology. 1984;22:91.

    Google Scholar 

  • Kern EB. Examination of nasal breathing: an objective method. In: Rees TD, Baker DC, Tabbal N, editors. Rhinoplasty: problems and controversies – a discussion with the experts. St. Louis: C.V. Mosby; 1988a.

    Google Scholar 

  • Kern EB. Surgery of the nasal valve. In: Rees TD, Baker DC, Tabbal N, editors. Rhinoplasty: problems and controversies – a discussion with the experts. St. Louis: C.V. Mosby; 1988b.

    Google Scholar 

  • Kern EB. Nasal valve surgery. In: Krause CJ, Mangat S, Pastorek N, editors. Aesthetic facial surgery. Philadelphia: J.B. Lippincott; 1991.

    Google Scholar 

  • Kern EB. Nasal obstruction. In: Meyerhoff WL, Rice DH, editors. Otolaryngology – head and neck surgery. Philadelphia: W.B. Saunders Company; 1992.

    Google Scholar 

  • Kern EB. Wegener’s granulomatosis and lethal midline granuloma. Summary of the fireside conference. In: Rhinology, supplement 14. Proceedings of the 1991 international congress of rhinology, 1992.

    Google Scholar 

  • Kern EB. The Preoperative discussion as a prelude to managing a complication. Arch Otolaryngol Head Neck Surg. 2003;129:1163.

    Article  PubMed  Google Scholar 

  • Kern EB, Wang TD. Nasal valve surgery. In: Daniel RK, editor. Rhinoplasty. New York: Little, Brown and Company; 1993.

    Google Scholar 

  • Khosh MM, Jen A, Honrado C, et al. Nasal valve reconstruction. Arch Facial Plast Surg. 2004;6:167.

    Article  PubMed  Google Scholar 

  • Kienstra MA, Sherris DA, Kern EB. The Cottle vs Joseph Rhinoplasty. In: Larrabee WF, Thomas RT, editors. Facial plastic surgery clinics of North America. Philadelphia: W. B. Saunders; 1999.

    Google Scholar 

  • Knops JL, McCaffrey TV, Kern EB. Physiology: clinical applications. Otolaryngol Clin North Am. 1993;26:517.

    PubMed  CAS  Google Scholar 

  • Kocer U. Effect of aesthetic rhinoplasty on respiratory functions. Aesthestic Plast Surg. 2001;25:202.

    Article  CAS  Google Scholar 

  • Lewin ML. Prevention and correction of cicatricial intranasal adhesions in rhinoplastic surgery. Arch Otolaryngol. 1954;60:415.

    Article  CAS  Google Scholar 

  • Lipton RJ, Kern EB. Nasal septal reconstruction. In: Pillsbury HC, Goldsmith MM, et al., editors. Operative challenges in otolaryngology – head and neck surgery. Part II: nasal and sinus surgery. Chicago: Year Book Medical Publishers; 1990.

    Google Scholar 

  • Martin C. http://www.emptynosesyndrome.org

  • McCaffrey TV, Kern EB. Clinical evaluation of nasal obstruction: a study of 1000 patients. Arch Otolaryngol. 1979;105:542.

    Article  PubMed  CAS  Google Scholar 

  • McCaffrey TV, Kern EB. Laryngeal regulation of airway resistance. I. Chemoreceptor reflexes. Ann Otol Rhinol Laryngol. 1980;89(3):209.

    PubMed  CAS  Google Scholar 

  • McCaffrey TV, Kern EB. Discussion of the effects of nasal surgery on airflow. In: Eugene H, Courtiss EH, Goldwyn RM. Plast Reconstr Surg. 1983;p. 20–21.

    Google Scholar 

  • McCaffrey TV, Kern EB. Rhinomanometry. In: Mackay I, editor. Facial plastic surgery. International quarterly monographs, vol. 3, rhinoplasty and airway. Thieme, Inc. New York, NY 1986;3:4:217.

    Google Scholar 

  • McKee GJ, O’Neill G, Roberts C, et al. Nasal airflow after septorhinoplasty. Clin Otolaryngol. 1994;19:254.

    Article  PubMed  CAS  Google Scholar 

  • Mertz JS, McCaffrey TV, Kern EB. Objective evaluation of anterior septal surgical reconstruction. Otolaryngol Head Neck Surg. 1984;92:308.

    PubMed  CAS  Google Scholar 

  • Miman MC, Deliktas H, Oxturan O, et al. Internal nasal valve: revisited with objective facts. Otolaryngol Head Neck Surg. 2006;134:41.

    Article  PubMed  Google Scholar 

  • Moore EJ, Kern EB. Atrophic rhinitis: a review of 242 cases. Am J Rhinol. 2001;15:355.

    PubMed  CAS  Google Scholar 

  • Moore GF, Freeman TJ, Ogren FP, Yonkers AJ. Extended follow-up of total inferior turbinate resection for relief of chronic nasal obstruction. Laryngoscope. 1985;95:1095.

    Article  PubMed  CAS  Google Scholar 

  • Nunez-Fernandez D, Vokurka J, Fernandez-Munoz G. Rhinoplasty, internal valve stenosis. http://emedicine.medscape.com/article/877468-overview

  • Olsen KD, Kern EB. Nasal influences on snoring and obstructive sleep apnea. In symposium on sleep disorders. Mayo Clin Proc. 1990;65:1095.

    Article  PubMed  CAS  Google Scholar 

  • Olsen KD, Kern EB, Westbrook PR. Sleep and breathing disturbances secondary to nasal obstruction. Otolaryngol Head Neck Surg. 1981;89:804.

    PubMed  CAS  Google Scholar 

  • O’Neill G, Tolley NS. Theoretical considerations of nasal airflow mechanics and surgical implications. Clin Otolaryngol. 1988;13:273.

    Article  PubMed  Google Scholar 

  • Ophir D, Schindel D, Halperin D, et al. Long-term follow-up of the effectiveness and safety of inferior turbinectomy. Plast Reconstr Surg. 1992;90:980.

    Article  PubMed  CAS  Google Scholar 

  • Ozturan O. Techniques for the improvement of the internal nasal valve in functional-cosmetic nasal surgery. Acta Otolaryngol. 2000;120:312.

    Article  PubMed  CAS  Google Scholar 

  • Pallanch JF, McCaffrey TV, Kern EB. Normal nasal resistance. Otolaryngol Head Neck Surg. 1985;93(6):778.

    PubMed  CAS  Google Scholar 

  • Pallanch JF, McCaffrey TV, Kern EB. Evaluation of nasal breathing function. Otolaryngol Head Neck Surg. Vol 1. 1993;37:665.

    Google Scholar 

  • Paniello RC. Nasal valve suspension: an effective treatment for nasal valve collapse. Arch Otolaryngol Head Neck Surg. 1996;122:1342.

    Article  PubMed  CAS  Google Scholar 

  • Park SS. The flaring suture to augment the repair of the dysfunctional nasal valve. Plast Reconstr Surg. 1998;101:1120.

    Article  PubMed  CAS  Google Scholar 

  • Parkes MH, Kanodia R. Avulsion of the upper lateral cartilage: etiology, diagnosis, surgical anatomy and management. Laryngoscope. 1981;91:758.

    Article  PubMed  CAS  Google Scholar 

  • Parkes MH, Kanodia R, Kern EB. The universal tip: a systematic approach to aesthetic problems of the lower lateral cartilage. Plast Reconstr Surg. 1988;81:878.

    Article  PubMed  CAS  Google Scholar 

  • Passali D, Passali FM, Passali GC, et al. Treatment of inferior turbinate hypertrophy: a randomized clinical trial. Ann Otol Rhinol Laryngol. 2003;112:683.

    PubMed  Google Scholar 

  • Pirsig W, Kern EB, Verse T. Reconstruction of anterior nasal septum: back-to-back autogenous ear cartilage graft. Laryngoscope. 2004;114:627.

    Article  PubMed  Google Scholar 

  • Pontell J, Slavit DH, Kern EB. The role of outfracture in correcting post rhinoplasty nasal obstruction. Ear Nose Throat J. 1998;77(2):106.

    PubMed  CAS  Google Scholar 

  • Rice DH, Kern EB, Marple BF, et al. The turbinates in nasal and sinus surgery: a consensus statement. Ear Nose Throat J. 2003;82(2):82.

    PubMed  Google Scholar 

  • Rizvi SS, Gauthier MG. Lateralizing the collapsed nasal valves simplified: 10-year survey of a simple concealed suture technique. Laryngoscope. 2011;121:558.

    Article  PubMed  Google Scholar 

  • Roithmann R, Chapnik J, Zamel N, et al. Acoustic rhinometric assessment of the nasal valve. Am J Rhinol. 1997;11:379.

    Article  PubMed  CAS  Google Scholar 

  • Saleh AM, Younes A, Friedman O. Cosmetics and function: quality-of-life changes after rhinoplasty surgery. Laryngoscope. 2012;122:254.

    Article  PubMed  Google Scholar 

  • Santiago-Diez DJ, McCaffrey TV, Kern EB. The nasal valve: a rhinomanometric evaluation of maximum nasal inspiratory flow and pressure curves. Ann Otol Rhinol Laryngol. 1986;95:229.

    Google Scholar 

  • Schlosser RJ, Park SS. Surgery for the dysfunctional nasal valve: cadaveric analysis and clinical outcomes. Arch Facial Plast Surg. 1999;1:105.

    Article  PubMed  CAS  Google Scholar 

  • Schulte DL, Sherris DA, Kern EB. M-Plasty correction of nasal valve obstruction. In: Larrabee WF, Thomas RT, editors. Facial plastic surgery clinics of North America. Toronto: W. B. Saunders; 1999.

    Google Scholar 

  • Sheen JH. Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty. Plast Reconstr Surg. 1983;73:230.

    Google Scholar 

  • Sherris DA, Kern EB. The versatile autogenous rib graft in septorhinoplasty. Am J Rhinol. 1998;12:221.

    Article  PubMed  CAS  Google Scholar 

  • Slavit DH, Lipton RJ, Kern EB, et al. Rhinolift operation in the treatment of the aging nose. Laryngoscope. 1990;103:462.

    CAS  Google Scholar 

  • Slavit DH, Bansberg SF, Facer GW, et al. Reconstruction of caudal end of the septum: a case for transplantation. Arch Otolaryngol Head Neck Surg. 1995;121:1091.

    Article  PubMed  CAS  Google Scholar 

  • Spielmann PM, White PS, Hussain SSM. Surgical techniques for the treatment of nasal valve collapse: a systematic review. Laryngoscope. 2009;119:1281.

    Article  PubMed  Google Scholar 

  • Stucker FJ, Lian T, Sanders K. Management of sever bilateral nasal wall collapse. Am J Rhinol. 2002;16:243.

    PubMed  Google Scholar 

  • Teichgraeber JF, Wainwright DJ. The treatment of nasal valve obstruction. Plast Reconstr Surg. 1994;93:1174.

    Article  PubMed  CAS  Google Scholar 

  • Toriumi DM, Josen J, Weinberger M, et al. Use of alar batten grafts for correction of nasal valve collapse. Arch Otolaryngol Head Neck Surg. 1997;123:802.

    Article  PubMed  CAS  Google Scholar 

  • Van Dishoeck HAE. Inspiratory nasal resistance. Acta Otolaryngol (Stockh). 1942;30:431.

    Article  Google Scholar 

  • Van Dishoeck HAE. The part of the valve and the turbinates in total nasal resistance. Int Rhinol. 1965;3:19.

    Google Scholar 

  • Webster RC, Davidson TM, Smith RC. Curved lateral osteotomy for airway protection in rhinoplasty. Arch Otolaryngol. 1977;103:454.

    Article  PubMed  CAS  Google Scholar 

  • Wexler DB, Davidson TM. The nasal valve: a review of the anatomy, imaging and physiology. Am J Rhinol. 2004;18:143.

    PubMed  Google Scholar 

  • Whicker JH, Kern EB. The nasopulmonary reflex in the awake animal. Ann Otol Rhinol Laryngol. 1973a;82:355.

    PubMed  CAS  Google Scholar 

  • Whicker JH, Kern EB. Effect of denervation of nasal mucosa on pulmonary mechanics. Ann Otol Rhinol Laryngol. 1973b;82:724.

    PubMed  CAS  Google Scholar 

  • White RG, Jones AS, Beckingham E. Trimming the inferior turbinates: a prospective long-term study. Clin Otolaryngol. 1990;15:347.

    Article  Google Scholar 

  • Williams HL. A reconsideration of the relation of the mechanics of nasal airflow to the function of the nose in respiration. Rhinology. 1972;10:145.

    Google Scholar 

  • Wittkopf M, Wittkopf J, Ries WR. The diagnosis and treatment of nasal valve collapse. Curr Opin Otolaryngol Head Neck Surg. 2008;16:10.

    Article  PubMed  Google Scholar 

  • Zambetti G, Moresi M, Romeo R, et al. Study and application of a mathematical model for the provisional assessment of areas and nasal resistance, obtained using acoustic rhinometry and active anterior rhinomanometry. Clin Otolaryngol. 2001;26:286.

    Article  PubMed  CAS  Google Scholar 

Supplemental Readings

  • Aiach G. Atlas de Rhinoplastic et de la Voie d’Abord Externe. Paris: Masson; 1993.

    Google Scholar 

  • Johnson CM, Toriumi DM. Open structure rhinoplasty. Philadelphia: Saunders; 1991.

    Google Scholar 

  • Peck GC. Techniques in aesthetic rhinoplasty. 2nd ed. Philadelphia: Lippincott; 1990.

    Google Scholar 

  • Rees TD. Aesthetic plastic surgery. Philadelphia: Saunders; 1980.

    Google Scholar 

  • Sheen JH, Sheen AP. Aesthetic rhinoplasty. 2nd ed. St. Louis: Mosby; 1987.

    Google Scholar 

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Kern, E.B. (2013). Physiologic Concerns During Rhinoplasty. In: Önerci, T. (eds) Nasal Physiology and Pathophysiology of Nasal Disorders. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37250-6_36

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