Recognition of patients who are at high risk for developing postrhinoplasty airway obstruction is essential. These patients may be at risk because of certain anatomic characteristics or may have a preexisting degree of airway obstruction from previous nasal surgery. Every surgeon who performs esthetic or reconstructive rhinoplasty procedures should be familiar with anatomic variants predisposing to airway obstruction and surgical techniques for airway improvement. The author presents case examples illustrating these principles and his methodology for recognizing and correcting airway compromise in primary and secondary rhinoplasty procedures. The use of spreader grafts, columellar graft, batten grafts, and piriform aperture widening are discussed. The author advocates incorporating these techniques to enhance nasal esthetics and function.
From the Division of Plastic and Reconstructive Surgery, Emory University, Atlanta, GA.
Received September 6, 2007 and accepted for publication, after revision, April 2, 2008.
Presented at the ASAPS annual meeting, Coronado Springs Resort, Lake Buena Vista, Florida, April 24, 2006.
Reprints: Fernando D. Burstein, MD, Suite 500, 975 Johnson Ferry Rd, Atlanta, GA 30342. E-mail: Fburstein@aol.com.