Sixth Bergamo Open Rhinoplasty Course

PROGRAM MARCH 16

Throughout the whole program you will find individual segments coded by three colors:
BASIC           INTERMEDIATE           ADVANCED
Although there is obviously wide overlap both in this classification and in individual interests irrespective of personal experience, color-coding will help you to best customize your learning track according to your learning requirements. Especially, green-coded sections should not be missed by beginners in rhinoplasty.

MORNING SESSIONS

06.15 – 06.45 COFFEE STATION AND REGISTRATION

Room A (Oggioni)

Morning sessions on Functional Rhinoplasty will focus on primary issues relevant to nasal obstruction: septum, turbinates and nasal valves. The current array of septoplasty techniques, which need to be essential components of modern rhinoplasty, will be fully addressed, together with new diagnostic and simulation tools. A Question-Time  Panel will review the functional issues which should be understood by non ENT surgeons. A Videofocus session will highlight septal and nasal valve maneuvers by the use of short tightly-edited videoclips. Keynote lectures will address the topics of Extracorporeal Septoplasty and Deviated Nose. A Crooked Nose Videocasepanel will demonstrate personal approaches to single cases of correction of deviated noses. A keynote lecture on Tip Sutures will end the morning and introduce the TIP afternoon topics.

06.45 – 08.20 Septum, Turbinates and Function
CHAIRS: Bussi, East

  • Septoplasty and Septal Reconstruction
  • Extracorporeal Septoplasty
  • Turbinates
  • New concepts for functional rhinoplasty
  • Preventing and managing obstruction
  • Endoscopy

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06.45 – 06.53 Palhazi – The Anatomy you have to know (Septum and Nasal Valves)
06.53 – 07.05 East – Septal Surgery overview and understanding the Nasal Valves
07.05 – 07.13 Lipski – Biomechanics of Septum, Cartilage Harvesting and Septal Reconstruction
07.13 – 07.21 Haack – Septal Reconstruction with Septal/ Ear / Rib cartilage grafts
07.21 – 07.29 Robotti – How to Harvest from the septum and How to Stabilize the L-strut: Perforated Ethmoid Plate applications
07.29 – 07.37 Apaydin – Bone Recycling in rhinoplasty
07.37 – 07.45 Racy – 3D modelling of the Internal Nasal Valve: New concepts for functional rhinoplasty
07.45 – 07.53 à Wengen – 15 years of experience with the Titanium Breathe Implant to open the internal nasal valve: may we consider this a safe technique?
07.53 – 08.01 Robotti – Cone Beam CT scan: does it offer true advantages in rhinoplasty?
08.01 – 08.09 Celik – Prevention and Management of Post-Rhinoplasty Nasal Obstruction
08.09 – 08.20 Q&A

 Room B (Alabastro)

07.00 – 13.00  6 one-hour Masterclasses
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08.20 – 08.35  Bussi – Special Topic: Why use Endoscopy in rhinoplasty?

08.35 – 09.00 Question-Time Panel – Functional issues which Non-ENT surgeons should understand
REVIEWERS: Robotti, Heppt
PANELISTS: Calvert, Celik, East, Gerbault, Kovacevic, Racy

09.00 – 09.20  Gubisch – Keynote Lecture 2 – Extracorporeal septoplasty: 30 yrs of experience and current refinements

09.20 – 9.45 COFFEE BREAK AND EXHIBITS

09.45 – 10.35  Septum/Function techniques Videofocus (videoclips-only session)
(3+1 formula: 3 min videoclip directly followed by 1 min discussion)
CHAIR: Kosins – Faculty will comment

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  1. East – How to deal with inferior and Middle Turbinates in nasal valve surgery
  2. Heppt – The Shaver Turbinoplasty
  3. Apaydin – Hybrid Grafts
  4. Gerbault – Ultrasonic Septoplasty
  5. Kosins – Subtotal septoplasty
  6. Racy – Protecting the Internal Nasal Valve during primary reduction rhinoplasty a) Scroll Flap
  7. Racy – Protecting the Internal Nasal Valve during primary reduction rhinoplasty b) Modified Spreader Flaps
  8. Dacho – Lower Lateral Crura Duplication to stabilize the outer valve
  9. Zholtikov – Variant of Septum Fixation using Piezo in the case without spine
  10. Lipski – Vestibular Skin Lifting
  11. à Wengen – Titanium Septum Plate to straighten and strengthen the Septum
  12. East – Suspension of the Lateral Alar Sidewall for valve dysfunction

10.35 – 11.05 Crooked Nose Videocasepanel
(Each Panelist presents in 5 minutes, exclusively by video, one case condensing the significant steps of surgery)
DISCUSSANTS: Davis, Haack 

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  • 1) Apaydin
  • 2) Cerkes
  • 3) Calvert
  • 4) East 
  • 5) Gubisch
  • Comments by Discussants (5 min)

11.05 – 11.25 Toriumi – Keynote Lecture 3: Management of the Deviated Nose Deformity

11.25 – 11.55  “Selected Abstracts” Corner and prize to best presentations
(4+1 formula: 4 min presentation directly followed by 1 min discussion)
CHAIR: Goksel

  • Gentileschi Stefano (Italy) – Precise spreader grafts fixation: An innovative and easy technique feasible open and closed rhinoplasty
  • Jallut Yves (France) – The Plunging or Smiling Tip
  • Manavba Y. Lker (Turkey) – Integrated caudal extension graft
  • San Nicolò Marion (Germany) – Piezoelectric Instrumentation vs. Conventional instruments. Is there a benefit in Rhinoplasty?
  • Silva Eduardo (Brazil) – Preop and postop assessment of external nasal valves in rhinoplasty
  • Wameedh Munjid Albassam (Oman) – Classification of caudal septal dislocation and management using multiple counteractive suture technique.

11.55 – 12.10 Follow-up on cases of the last Course with comments by surgeon

12.10 – 12.30  Daniel – Keynote Lecture 4 – Tip Sutures: a 30 year evolution

12.00 – 14.00  LUNCH AND EXHIBITS

12.30 – 13.00  Room C (Stucchi) – Lunchtime Industry Workshop: 3-D Computer Simulation by digital imaging (Vectra 3D)

The benefits of 3-D digital imaging will be addressed, including its marketing value for potential patients. 
HELD BY: Rollin Read

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This workshop will provide examples and instruction on using 3D imaging for rhinoplasty. The workshop will focus on using 3D models for patient communication and surgical planning using simulation and precise quantitative analysis of the anatomy. The workshop will also explore measuring and assessing outcomes using pre and post 3D models.

13.00 – 13.30  Room B (Alabastro) – Lunchtime Industry Workshop: Powered Rhinoplasty System: how to use it and why

This workshop will deal with the practical aspects of the Powered Rhinoplasty system and the benefits for the patients.
HELD BY: Emmanuel Racy

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The reasons and benefits of using Powered Rhinoplasty tools will be demonstrated. The required learning curve will be shortened by sharing the professional experience and the many tips and tricks on the Powered Rhinoplasty system.
The participants will have the opportunity of learning the surgical technique by a lecture combined with surgical videos presenting specific cases, as well as a step-by-step video using a 3d printed artificial specimen. The system can then be individually tried on 3D printed bone at the Bien Air stand.

AFTERNOON SESSIONS

All afternoon sessions will address the TIP. Session 1 will address the key tip issues, while Session 2 will cover important tip specifics/hot topics. A Tip Hot Topics Videopanel will demonstrate techniques of providing tip support as well as address finesse issues of domal and sidewall configuration . A “Boxing-Ring” panel will shed light on controversial issues of tip management and a Tip Techniques Videofocus session will end the day highlighting by the use of short tightly-edited videoclips specific operative details and personal pearls

13.30 – 15.20 Session 1: Tip issues
CHAIRS: Daniel, Calvert

  • Sutures and Grafts
  • Increasing and decreasing Projection/Length/Rotation
  • Alar Base

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13.30 – 13.35  Palhazi – The Anatomy you have to know (Tip)
13.35 – 13.50 Toriumi – Contouring the Nasal Tip: raising the bar
13.50 – 14.05 Foda – Managing Tip Projection and Rotation
14.05 – 14.20 Davis – Tip “Tensioning”; Enhancing Outcomes with Tip Dynamics
14.20 – 14.30 Calvert – Nuances in Tip Suturing
14.30 – 14.40 Rowe Jones – Essentials in treating the Bulbous Tip and the Drooping Tip
14.40 – 14.50 Sykes – Placing Tip Graft: Which grafts and What is the best order
14.50 – 15.00 Cerkes – Lengthening the Short Nose
15.00 – 15.10 Rohrich – Finesse in Alar Base Surgery
15.10 – 15.20 Q&A

15.20 – 16.20 Session 2: Tip specifics/hot topics
DISCUSSANTS: Foda, Gerbault

  • Alar/Columellar Disproportion
  • Reshaping and Repositioning the Lateral Crura
  • Alar Rim

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15.20 – 15.28 Sykes – The Alar-Columellar Relationship: Diagnosis and Treatment
15.28 – 15.36 Foda – Management of the Hanging Infratip Lobule
15.36 – 15.44 Rohrich – Getting the Alar Rim Contour right: key principles and nuances
15.44 – 15.52 Zholtikov – Lateral crura Transposition: why, when, how. Tips and tricks
15.52 – 16.00 Ghavami – Lateral Crural Transection: Safe and Effective
16.00 – 16.05 Cobo – Alar Rim Grafts or Alar Contour Grafts: what do they really do?
16.05 – 16.10 Apaydin – Lateral Crura Turn-In Flaps: do they work long term?
16.10 – 16.15 5 min for the Discussants
16.15 – 16.20 Q&A

16.20 – 16.40  COFFEE BREAK AND EXHIBITS

 Room B (Alabastro) – BREAKOUT PARALLEL SESSION

15.20 – 16.30 3D VIDEOSESSION – VITOM 3D (3D viewing glasses provided)
CHAIRS: Bussi, Heppt
DISCUSSANT: Rowe Jones
TOPICS: Complete open rhinoplasty, valve lift, turbinoplasty, endoscopic septoplasty

This innovative session will include 3D videos shot, edited and shown in 3D. Videos are directly discussed on stage. The potential operative and didactic benefits of the VITOM 3D system both in endoscopic as well as external rhinosurgery are the subject of this session and will be tested by the attendees with the use of the viewing glasses provided.

INTERACTIVE VIDEO PRESENTATIONS
15.20 – 15.30 Bussi, Heppt – Introduction and technical details of 3D Vitom®
15.30 – 15.45 Bussi – (Cadaver) Dissection: the added value of the 3D tool
15.45 – 16.00 Heppt  – (Open rhino) Correction of hump and droopy nose.
16.00 – 16.10 Heppt – (Endoscopic) Endoscopic airstream surgery: Septum, turbinates, valve lift with Silhouette® threads
16.10 – 16.20 Bussi – OR Setting and procedure  of a 3D managed rhinoplasty
16.20 – 16.30 Discussion of pros and cons

Room A (Oggioni)

16.40 – 17.50 Tip Hot Topics Videopanel
(5 min video-based presentations in each group followed by 5 min discussion at end of each group) 
REVIEWERS: Davis, Daniel

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16.40 – 17.10 Group 1Supporting the Tip

  • 1) Rohrich – Role of Columellar struts in tip reshaping
  • 2) Daniel – Modified Tongue-In-Groove
  • 3) Davis – End-to-End Septal Extension Graft: design and fixation
  • 4) Cobo – End-to-Side Septal Extension Graft and its role in modifying the acute nasolabial angle
  • 5) Sykes – Caudal Septal Extension Graft for repositioning the tip
  • Discussion by Reviewers (5 min)

17.10- 17.50 Group 2Addressing domes, lateral crura and sidewall

  • 1) Kovacevic – Cranial Tip Suture and tip shape
  • 2) Davis – The Cap Graft for enhanced tip aesthetics
  • 3) Bruschi – Seagull Graft – a three-in-one graft: where and when
  • 4) Celik – “Butterfly” Rim Grafts and their use to correct cephalic malposition
  • 5) Goksel – Oblique Turn Over for flattening and repositioning of the lateral crura
  • 6) Kovacevic – Alar Transposition with Caudal Turn-in Flap
  • 7) Rohrich – Alar Rim/Soft Triangle Reshaping with Butterfly Grafts/Extended Alar Contour Grafts
  • Discussion by Reviewers (5 min)

17.50 – 18.20 Tip Controversies Boxing-Ring Panel
( 2 surgeons pro and 2 against for each topic 5 min for each opposing duo to state their points, followed by 5 min discussion on each topic)
TOPICS: TIP SUPPORT: Strut vs Septal Extension Graft vs Tongue-In-Groove – LATERAL CRURA MALPOSITION: Transposition vs Alternatives
REFEREES: Rohrich, Toriumi

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  1. STRUT (Cerkes, Foda)  vs  SEG / TIG (Cobo, Davis)
  2. TRANSPOSITION pro (Cerkes, Sykes )  against (Apaydin, Davis)

18.20 – 18.30 Robotti – 10 min for Wrapping the Tip up

18.30 – 20.15 “Tip techniques videofocus” (videoclips-only session)
(3+1 formula: 3 min videoclip directly followed by 1 min discussion)
CHAIR: Bruschi – Faculty will comment

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  1. APAYDIN – Shoe-lace suturing of the Columellar Strut
  2. DAVIS – Tongue-In-Groove setback fixation for improved nasal base profile aesthetics
  3. DURON – How to Support the nose with no graft in primary rhinoplasty (TIG+spreader flap)
  4. GUBISCH – End-To-End fixation of Septal Extension Graft
  5. KOSINS – Fine tuning the Septal Extension Graft
  6. KOVACEVIC – Step-Septal Extension Graft: a new option
  7. COBO – Septocolumellar Sling suture
  8. COBO – Angulated Dome-Defining and Lateral Crura Steal sutures
  9. BRUSCHI – Tuning tip projection with Directional Sutures
  10. ROWE JONES – Shield Graft design and placement
  11. APAYDIN – Alar Batten: an often neglected gem
  12. ANTOHI – Sidewall strengthening with Radiofrequency
  13. PAUN – The Lateral Crural Flap technique
  14. KUZANOV – Reinforcement of weak lower lateral crura with septal grafts
  15. DURON – Correction of Lateral crura convexity with deep graft
  16. KOSINS – Lateral steal and medial crural overlap – a powerful combination for the overprojected tip
  17. CERKES – Lateral Crura Transposition
  18. APAYDIN – Lateral Crura Turn-in flap and repositioning of the lateral crura
  19. ROBOTTI – Correcting intermediate crura excess/asymmetry
  20. SYKES – Alar Turn-in flaps and Alar Rim Grafts
  21. DAVIS – Articulated Alar Rim grafts fixation and pocketing
  22. COBO – Alar Rim Grafts placement techniques
  23. ROBOTTI – Septal T: uses and tips
  24. GHAVAMI – A novel versatile graft for the Soft Triangle
  25. FODA – Narrowing the nasal base
  26. CELIK – Alar base resection

20.15  Adjourn

21.00  SOCIAL DINNER