Reconstruction of the nasal soft triangle subunit

Fadi C. Constantine, Michael R. Lee, Sammy Sinno, James F. Thornton

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

BACKGROUND:: Of all nine subunits, the soft triangle is perhaps the most challenging to recreate. The complexity of soft triangle reconstruction resides in its proximity to such important structures as the nasal tip, nasal ala, and distal columella. If the soft triangle is not properly reconstructed, problems with nasal function and aesthetics often arise. Anatomical asymmetries in the lower third and abnormal shadowing can occur following insufficient restoration. METHODS:: A retrospective review was completed of all patients undergoing reconstruction of the nasal soft triangle subunit at the University of Texas Southwestern Medical Center in Dallas, Texas, from 1995 to 2010. Defects with only external skin intact were classified as type I. Defects involving both skin and underlying soft tissue with intact mucosa were classified as type II. Finally, transmural defects with violated mucosa were classified as type III. Surgical outcomes were graded on a scale of I to IV. Grades given were based on the complexity of the existing defect and restoration of the soft triangle, with higher grades given when adjacent structures were not distorted. RESULTS:: Of the 14 cases reviewed, two (14 percent) were type I defects, nine (64 percent) were type II defects, and three (21 percent) were type III defects. Three patients (21 percent) required revision with subsequent resurfacing and two (14 percent) required resurfacing alone. All but one patient (93 percent) had a grade of 2.0 or better, with the one patient opting not to undergo revision. CONCLUSIONS:: The authors believe their method of soft triangle reconstruction using the proposed algorithm is an easy approach to soft triangle reconstruction that will yield consistent surgical and clinical success from aesthetic and functional perspectives. Furthermore, the authors were able to achieve excellent aesthetic outcomes without compromise or facing any structural complications. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.

Original languageEnglish (US)
Pages (from-to)1045-1050
Number of pages6
JournalPlastic and Reconstructive Surgery
Volume131
Issue number5
DOIs
StatePublished - May 2013

Fingerprint

Nose
Esthetics
Mucous Membrane
Skin
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Reconstruction of the nasal soft triangle subunit. / Constantine, Fadi C.; Lee, Michael R.; Sinno, Sammy; Thornton, James F.

In: Plastic and Reconstructive Surgery, Vol. 131, No. 5, 05.2013, p. 1045-1050.

Research output: Contribution to journalArticle

Constantine, Fadi C. ; Lee, Michael R. ; Sinno, Sammy ; Thornton, James F. / Reconstruction of the nasal soft triangle subunit. In: Plastic and Reconstructive Surgery. 2013 ; Vol. 131, No. 5. pp. 1045-1050.
@article{0a944f1f02874b3b8a432cfdf6138804,
title = "Reconstruction of the nasal soft triangle subunit",
abstract = "BACKGROUND:: Of all nine subunits, the soft triangle is perhaps the most challenging to recreate. The complexity of soft triangle reconstruction resides in its proximity to such important structures as the nasal tip, nasal ala, and distal columella. If the soft triangle is not properly reconstructed, problems with nasal function and aesthetics often arise. Anatomical asymmetries in the lower third and abnormal shadowing can occur following insufficient restoration. METHODS:: A retrospective review was completed of all patients undergoing reconstruction of the nasal soft triangle subunit at the University of Texas Southwestern Medical Center in Dallas, Texas, from 1995 to 2010. Defects with only external skin intact were classified as type I. Defects involving both skin and underlying soft tissue with intact mucosa were classified as type II. Finally, transmural defects with violated mucosa were classified as type III. Surgical outcomes were graded on a scale of I to IV. Grades given were based on the complexity of the existing defect and restoration of the soft triangle, with higher grades given when adjacent structures were not distorted. RESULTS:: Of the 14 cases reviewed, two (14 percent) were type I defects, nine (64 percent) were type II defects, and three (21 percent) were type III defects. Three patients (21 percent) required revision with subsequent resurfacing and two (14 percent) required resurfacing alone. All but one patient (93 percent) had a grade of 2.0 or better, with the one patient opting not to undergo revision. CONCLUSIONS:: The authors believe their method of soft triangle reconstruction using the proposed algorithm is an easy approach to soft triangle reconstruction that will yield consistent surgical and clinical success from aesthetic and functional perspectives. Furthermore, the authors were able to achieve excellent aesthetic outcomes without compromise or facing any structural complications. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.",
author = "Constantine, {Fadi C.} and Lee, {Michael R.} and Sammy Sinno and Thornton, {James F.}",
year = "2013",
month = "5",
doi = "10.1097/PRS.0b013e3182879ea7",
language = "English (US)",
volume = "131",
pages = "1045--1050",
journal = "Plastic and Reconstructive Surgery",
issn = "0032-1052",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Reconstruction of the nasal soft triangle subunit

AU - Constantine, Fadi C.

AU - Lee, Michael R.

AU - Sinno, Sammy

AU - Thornton, James F.

PY - 2013/5

Y1 - 2013/5

N2 - BACKGROUND:: Of all nine subunits, the soft triangle is perhaps the most challenging to recreate. The complexity of soft triangle reconstruction resides in its proximity to such important structures as the nasal tip, nasal ala, and distal columella. If the soft triangle is not properly reconstructed, problems with nasal function and aesthetics often arise. Anatomical asymmetries in the lower third and abnormal shadowing can occur following insufficient restoration. METHODS:: A retrospective review was completed of all patients undergoing reconstruction of the nasal soft triangle subunit at the University of Texas Southwestern Medical Center in Dallas, Texas, from 1995 to 2010. Defects with only external skin intact were classified as type I. Defects involving both skin and underlying soft tissue with intact mucosa were classified as type II. Finally, transmural defects with violated mucosa were classified as type III. Surgical outcomes were graded on a scale of I to IV. Grades given were based on the complexity of the existing defect and restoration of the soft triangle, with higher grades given when adjacent structures were not distorted. RESULTS:: Of the 14 cases reviewed, two (14 percent) were type I defects, nine (64 percent) were type II defects, and three (21 percent) were type III defects. Three patients (21 percent) required revision with subsequent resurfacing and two (14 percent) required resurfacing alone. All but one patient (93 percent) had a grade of 2.0 or better, with the one patient opting not to undergo revision. CONCLUSIONS:: The authors believe their method of soft triangle reconstruction using the proposed algorithm is an easy approach to soft triangle reconstruction that will yield consistent surgical and clinical success from aesthetic and functional perspectives. Furthermore, the authors were able to achieve excellent aesthetic outcomes without compromise or facing any structural complications. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.

AB - BACKGROUND:: Of all nine subunits, the soft triangle is perhaps the most challenging to recreate. The complexity of soft triangle reconstruction resides in its proximity to such important structures as the nasal tip, nasal ala, and distal columella. If the soft triangle is not properly reconstructed, problems with nasal function and aesthetics often arise. Anatomical asymmetries in the lower third and abnormal shadowing can occur following insufficient restoration. METHODS:: A retrospective review was completed of all patients undergoing reconstruction of the nasal soft triangle subunit at the University of Texas Southwestern Medical Center in Dallas, Texas, from 1995 to 2010. Defects with only external skin intact were classified as type I. Defects involving both skin and underlying soft tissue with intact mucosa were classified as type II. Finally, transmural defects with violated mucosa were classified as type III. Surgical outcomes were graded on a scale of I to IV. Grades given were based on the complexity of the existing defect and restoration of the soft triangle, with higher grades given when adjacent structures were not distorted. RESULTS:: Of the 14 cases reviewed, two (14 percent) were type I defects, nine (64 percent) were type II defects, and three (21 percent) were type III defects. Three patients (21 percent) required revision with subsequent resurfacing and two (14 percent) required resurfacing alone. All but one patient (93 percent) had a grade of 2.0 or better, with the one patient opting not to undergo revision. CONCLUSIONS:: The authors believe their method of soft triangle reconstruction using the proposed algorithm is an easy approach to soft triangle reconstruction that will yield consistent surgical and clinical success from aesthetic and functional perspectives. Furthermore, the authors were able to achieve excellent aesthetic outcomes without compromise or facing any structural complications. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.

UR - http://www.scopus.com/inward/record.url?scp=84877737857&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877737857&partnerID=8YFLogxK

U2 - 10.1097/PRS.0b013e3182879ea7

DO - 10.1097/PRS.0b013e3182879ea7

M3 - Article

C2 - 23385988

AN - SCOPUS:84877737857

VL - 131

SP - 1045

EP - 1050

JO - Plastic and Reconstructive Surgery

JF - Plastic and Reconstructive Surgery

SN - 0032-1052

IS - 5

ER -