Dr. Mohammed saad aldin aly elsayed
King Abdullah Medical City, Saudi Arabia
Title: Deep Temporalis Fascia Blanketing Supra- SMAS (superficial musculoaponeurotic) layer Versus Sub-SMAS layer dissection and preservation in preventing nasal dorsal irregularities in Arabic Thick Skin Patients
Biography
Biography: Dr. Mohammed saad aldin aly elsayed
Abstract
Background:
Rhinoplasty is a complex surgical procedure used to correct nasal deformities. The main aim of this procedure is to improve the function and aesthetic aspect of the nose, enhancing facial harmony and the symmetry of the nose. It is considered as one of the most challenging operations in the field of Otolaryngology practice. In primary rhinoplasty, the two common techniques used are sub superficial musculoaponeurotic system (Sub-SMAS) layer dissection and Supra SMAS deep Temporalis Fascia (DTF)blanketing for prevention of dorsal nasal irregularities in thick skin Arabic patient . The aim of this study is to compare the irregularity of the nasal dorsum after rhinoplasty between (DTF)blanketing supra SMAS layer and(Sub-SMAS) layer dissection and preservation in primary thick skin Arabic rhinoplasty surgery .
Methods:
The study was approved by institutional review board (IRB). A retrospective chart study was conducted on (64) patients who presented to (ENT Out Patient Department) and underwent primary rhinoplasty at tertiary care, Saudi Arabia. Patients were divided equally into2 groups,50%(32) Patients underwent (DTF)blanketing .and 50%(32) patients underwent(Sub-SMAS) layer dissection. Data was collected by observing the preoperative and postoperative dorsal aesthetic lines symmetry outcomes .Data were tabulated using Microsoft excel sheet,SPSS used for Statistical analysis .Comparison between groups made by Student’s, t-test and Chisquare test for categorical Values
Result:
Postoperative nasal dorsal aesthetic line symmetry observation in thick skin Arabic patient score was given for both the groups raging from (1,2,3,4,5), 1 means-0% marked dorsal aesthetic line symmetry,2- 25% symmetry, 3- 50% symmetry four 75% symmetry and 5-100% symmetry. It was seen that25.8% of patient with temporalis fascia blanketing supra SMAS layer had a score (5), 12.9% had score International Journal of Scientific & Engineering Research Volume 8, Issue 9, September-2017 185 (4), 38.7% score (3), 12.9% score (2) and 9.7% had score (1), while 36.4% of patient with(Sub-SMAS) layer dissection had score (5), 33.3% score (4) , 24.2% score (3) and 6.1 % score (2). The mean score in patients before (DTF) blanketing supra SMAS. was 2.25 and 3.32 after the surgery, while the mean score in patients (Sub-SMAS) layer dissection group was 1.97 and 4 after the surgery. The postoperative dorsal nasal irregularity observation showed that 87.1% of patients with (DTF)blanketing supra SMA Slayer,have a regular nose while 12.9% of patients have irregular nasal dorsal.87.9 % of patient with (Sub-SMAS) layer dissection have a regular nasal dorsum. while 12.1 % of them have irregular nose as the t test was significant.