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The saddle nose deformity is associated with dorsal collapse and can have both function and cosmetic problems. The saddle nose can cause nasal obstruction by narrowing the nasal cavities, eliciting dynamic internal and external nasal valve narrowing, and abnormally widening the internal and external nasal valves altering airflow dynamics, sinonasal passageways, and olfaction. The saddle nose is challenging to treat due to skin contracture, lack of donor tissue, and difficulties in esthetic integration. A focus on balancing the functional and esthetic concerns during treatment is paramount., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Rhinoplasty is a challenging surgery and results are not always perfect. There are many obstacles to achieving optimal results. Among these are inadequate instrumentation, the unpredictability of healing, imprecise planning, and many more. Furthermore, selecting patients who can most benefit from surgery is equally important. In this article, some of the more pressing areas of rhinoplasty that need innovation are discussed. From proper patient selection, to advances in education, to the standardization of training programs, to the development of sophisticated implants, the future of rhinoplasty surgery lies in continued creativity and innovation., Competing Interests: None declared., (Thieme. All rights reserved.)

Rhinoplasty surgeons must continually strive to refine and improve their results. Improvement may be borne out of new surgical techniques, alternative perioperative medicines, or through the application of new technologies. One technology that has recently gained popularity are piezoelectric osteotomes (POs). These instruments offer a powered alternative to the traditional chisel osteotome. This article provides a history of these two modalities, reviews the most recent data surrounding piezoelectric osteotomy, and provides a framework to compare the pros and cons of each osteotomy option., Competing Interests: None declared., (Thieme. All rights reserved.)

Many dilemmas in rhinoplasty tempt surgeons to use exogenous materials. We have long looked toward implants to decrease operative time, to achieve a more reliable result, or when there is a paucity of autologous material. More than ever, the innovative and highly lucrative field of nasal implantology is developing technologically advanced products. This article looks at some popular nasal implant choices with a look toward what might be on the horizon., Competing Interests: None declared., (Thieme. All rights reserved.)

Septorhinoplasty is among the most common facial plastic and reconstructive surgeries and its complexities are reflected in a relatively high revision rate. The patient with a postoperative twisted nose presents an additional challenge and requires that the surgeon display empathy and possess a deep knowledge of the aesthetic and functional intricacies of the nose. Correction of the twisted nose should be approached in a systematic fashion with unique considerations for each "third" of the nose. While there are many options in the overall surgical armamentarium, each surgeon will find specific techniques that are most efficacious and reproducible for their individual practice. This article discusses select surgical "pearls" and techniques that can aid the surgeon in their own surgical decision-making., Competing Interests: None., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Objective: To evaluate whether a diagnosis of allergic rhinitis affects surgical outcomes of open septorhinoplasty (OSR) and to examine whether OSR provides the same level of improvement in quality of life to patients with and without allergic rhinitis., Study Design, Setting, Subjects and Methods: We performed a retrospective evaluation of 646 patients who underwent open septorhinoplasty in a tertiary otolaryngology practice between 2008 and 2015. Preoperative and postoperative quality of life (QoL) measurement using the validated Nasal Obstruction Symptom Evaluation (NOSE) Scale was performed on 307 patients meeting inclusion criteria. These patients were then divided into two groups based on a diagnosis of allergic rhinitis (non-AR vs AR). Comparisons were then made based on quality of life improvements by the NOSE score., Results: There were 213 patients in the non-AR group vs. 94 patients in the AR group. After OSR, patients in both groups experienced significant improvement in nasal airway obstruction. Pre-op NOSE score averages were similar for the non-AR and AR groups (69.9 vs 73.4 p = 0.087). Average improvement in NOSE score for the non-AR and AR groups at 30 days was 48.6 vs 45.9 (p = 0.41); and at 90 day of 48.1 vs 51.5 (p = 0.402)., Conclusion: Patients with and without allergic rhinitis experience similar OSR outcomes as measured by the NOSE score. Open septorhinoplasty addresses multiple components contributing to nasal airway obstruction, and may offset the effects of allergic rhinitis. When indicated, it should be offered to patients with allergic rhinitis after complete medical management., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Introduction: The effect of marijuana on human health has been studied extensively. Marijuana intoxication has been shown to affect performance, attention span, and reaction time. The public health relationship between trauma and cannabis use has also been studied, with mixed conclusions. In this report, the effect of marijuana legalization on many aspects of facial trauma at two hospitals in Denver, Colorado is examined., Methods: A retrospective review of the electronic medical records was undertaken. Mann-Whitney U tests were used to compare age of patients before and after legalization, and chi squared analyses were used to compare mechanism of injury, and fracture types before and after recreational marijuana legalization in Denver, Colorado. Geographical location of patients was also considered., Results: No significant increase was found in race before and after marijuana legalization (p=0.19). A significant increase in age was found before (M=39.54,SD=16.37), and after (M=41.38,SD=16.66) legalization (p<0.01). Maxillary and skull base fracture proportions significantly increased following legalization (p<0.001 and p<0.001respectively). No significant differences were seen in the proportion of patients who lived in urban and rural counties before and after legalization (p>0.05)., Conclusion: Public health efforts should be directed towards educating residents and visitors of Colorado on the effects and toxicology of marijuana. More epidemiologic studies are needed for further assessment of the long-term effects of the legalization of marijuana on the population., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Silver nanoparticles (AgNPs) have attracted great attention due to its optical, electrical and thermal properties. Cellulosic supports for these nanoparticles are of particular interest because of its availability, flexibility and biocompatibility. In this work, AgNPs were synthesized using two cellulosic materials, cellophane (CP) and filter paper (FP), as matrix support. Cellulosic materials were immersed in an aqueous solution of silver nitrate containing polyvinylpyrrolidone (PVP) and then reduced with hydroxylamine. The obtained nanocomposites (CP-AgNPs and FP-AgNPs) were characterized by Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (DRX) and scanning electron microscopy (SEM). AgNPs of near 15nm anchored onto cellulosic surfaces were detected. The thermal properties of these materials were investigated through thermogravimetry (TG). Their kinetic of thermal decomposition was studied by the Vyasovkin method of dynamic isoconvertion, which indicated a catalytic effect of AgNPs in the cellulose thermal decomposition reaction., (Copyright © 2015 Elsevier Ltd. All rights reserved.)