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96 IMPACT OF DOME SPLITTING ON THE NASAL AIRFLOW EFFICACY OF EXTERNAL AIRWAY BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS
Sina Seyed Abbaszadeh et al.
xed medially at the collumella and at the lateral border
of the alar. Lower lateral cartilage holds up the soft tissue
of the nasal tip (Constantinides et al. 1996). If the carti-
lage get weaker, is was not able to maintain support of
the soft tissue which horizontal excision will contribute
to collapse and compromise at the nasal valve (Richard
et al. 1998). In a study on impact of vertical dome divi-
sion on nasal air ow, Conrad et al. (2000) reported the
air ow was negatively affected in 37.5% and improved
postoperatively in 25% of patients. The protocol which
they applied in their research was differ from ours.
Recently Gandomi et al. (2011) reported the modi ed
vertical dome technique is an effective method for nasal
tip de-projection and narrowing via an open approach.
Despite several research efforts, studies evaluating qual-
ity-of-life outcomes after nasal tip surgery with dome
division surgery remain scarce in the facial plastic sur-
gery literature. In the current study, we used dome divi-
sion technique to determine its effects on nasal air ow.
We think obtained results of the current study can use
as base information for accuracy of this technique on
patients breathing. It is reported dome division tech-
nique improved the life quality of the patients during
a short period (Lavinsky-Wolff et al. 2013) which the
protocol applied in our study was different from incom-
ing research.
In a study on comparison of suture and vertical dome
division techniques of bulbous nose re nement, Ghaz-
ipour et al. (2011) was reported among the 35 patients
with transdomal and interdomal technique, 2 patients
(7.5%) had a previous bulbous nose deformity remained
stable of whom one patient resulted in revision sur-
gery. The overall satisfaction rate in these patients
was approximately 92%. Also, in 35 patients with who
underwent surgery using vertical dome division method,
in 3 patients (6.8%) complication as over narrowing
nasal tip was observed which in one case this led to
revision surgery and in one case (2.8%) collapse of lower
lateral cartilage occurred. Base on their report it seems
vertical dome division is effective for life quality of
the patients while in the current study obtained results
revealed vertical dome division leads to nasal obstruc-
tion. Despite these limitations, our results add relevant
quality-of-life data to the rhinoplasty literature, includ-
ing speci c information about the outcomes of vertical
dome division surgery in patients. In conclusion results
suggested rhinoplasty surgery using dome splitting
decreased the nasal air ow ef cacy after the surgery.
So care must be exercised for alterations in nasal air
ow resistance when manipulating the nasal framework
is done.
REFERENCES
Adamson P, Smith O, Cole P: 1990. The effect of cosmetic rhi-
noplasty on nasal patency. Laryngoscope 100:357-359,
Chang CW, Simons RL. 2008. Hockey-Stick Vertical Dome
Division Technique for Overprojected and Broad Nasal Tips.
Arch Facial Plast Surg 10: 88-92.
Conrad K, Solomon P, Chapnik JS. 2000. Impact of vertical
dome division on nasal air ow. J Otolaryngol 29(3):162–165.
Constantinides MS, Adamson PA, Cole P: 1996. The long-term
effects of open cosmetic septorhinoplasty on nasal air ow.
Arch Otolaryngol Head Neck Surg 122:41-45,
Duron JB,Bardot J,Aiach G, Nguyen PS, Nostrils. 2014 Surgery.
Ann Chirp last Esthet Des:596:52206
Ettorre G, Weber M, Schaaf H, Lowry JC, Mommaerts MY,
Howaldt HP.2006. Standard for digital photography in cranio-
maxillo-facial surgery- Part I: Basic view & guidelines. J
Canio-Maxillofac Surg 34(2):65-73.
Foda H.M.T. 2013 External rhinoplasty for the overprojected
nasal tip. J Ästhet Chir 6:26–32.
Foda HM.2001. Alar setback technique: a controlled method
of nasal tip deprojection. Arch Otolaryngol Head Neck Surg
127: 1341-6.
Funk E, Chauhan N, Adamson PA.2009. Re ning vertical lob-
ule division in open septorhinoplasty. Arch Facial Plast Surg
11(2):120–125
Gandomi B, Arzaghi MH, Rafatbakhsh M.2011 The Effective-
ness of modi ed vertical dome division technique in reducing
nasal tip projection in rhinoplasty. Iran J Med Sci 36(3): 196-
200.
Hamilton A, Grant S 2014. Y-V alar base reduction. Ear, Nose
& Throat Journal ;93,3,98.
Kridel RW, Konior RJ. 1990. Dome truncation for management
of the overprojected nasal tip. Ann Plast Surg 24: 385-96.
Lavinsky-Wolff M, Lutaif Dolci JE, Camargo HL, Manzini M,
Petersen S, Romanczuk S, , Pizzoni R, Polanczyk CA. 2013.
Vertical dome division: A quality-of-life outcome study. Oto-
laryngology– Head and Neck Surgery 148(5) 758–763.
Pi H, Kurlander DE, Guyuron B.2016 Effects of the rhinoplasty
maneuvers on upper lip position and incisor show. Aesth Plast
Surg :1-5.
Richard E. Goulding, MD, Laura L. Scott, RN.1998. Vertical dome
division for nasal valve incompetence operative techniques in
otolaryngology--head and neck surgery, 9(2): 107-116
Simons RL, Fine IJ. 1977. Evaluation of the Goldman tip in
rhinoplasty. In: Plastic and Reconstructive Surgery of the Face
and Neck: Proceedings of the Second International Sympo-
sium. New York, NY: Grune & Stratton; 39–46
Yoo S., Most SP. 2011. Nasal airway preservation using the auto-
spreader technique. Arch Facial Plast Surg. 13(4):231-233.