External septorhinoplasty.

One of the disadvantages of the usual endonasal technique of rhinoplasty is the poor surveyability of the surgical field. By joining the left and right marginal incision via a transverse columellar incision and elevating the skin of the columella and the dorsum nasi, the infrastructure of the nose can be exposed. The good exposition results in a meticulous surgery of the nasal dorsum, precise correction of the triangular cartilages, good access to the septum and more a-curate augmentation procedures of the prespinal area, columella or nasal dorsum. This "external" approach is more or less a synthesis of the subcutaneous endonasal method and surgery under visual control, with the only sacrifice of a small scar which has marked advantages on the other hand. The results of the external approach to septorhinoplasty in 30 patients with cosmetic and functional complaints are discussed. No complications attributable to the method were seen. Especially for difficult cases as revisional operations, congenital nasal deformities and multiple traumatic damaged noses the external approach appears to be very useful.