■ Management of the External and Internal Valves in Rhinoplasty
B – Comprehensive
There are four valves in the human nose: Septal valve, turbinal valve, internal valve and external valve. The internal valve is the narrowest part of the whole respiratory tract. In reduction rhinoplasty, the surgeon usually narrows the internal valve area after hump removal. Different uses of spreader flaps or grafts, butterfly grafts should be used in order to prevent internal valve problems. External valve is usually the neglected part for decades. Lateral crura have been aggressively resected throughout the history of rhinoplasty. Unfortunately, this aggressive behaviour is still observed in revision cases. Besides, the anatomic variants of the lateral crura in terms of shape and position should also be assessed and addressed by using lateral crural turn-in flap, lateral crural strut graft, alar batten graft, rim graft and alar repositioning. All these techniques will be presented with some pitfalls by means of different case examples and video clips.
- To present the etiology of the internal and external valve problems.
- To present the solutions to reconstitute the normality of these valves.