Elliptic excision of the upper lateral cartilage in the rhinoplasty for correction of the large middle third

Introduction: The reduction of the large nasal dorsum is a critical step for rhinoplasty because it works in the nasal valve area with the challenge of a favorable aesthetic result without functional damage. Method: We used a modified method of reduction of the upper lateral cartilage, through elliptic excision, aiming to reduce the width of the nasal middle third. The inner nasal valve structure, the relationship of the upper lateral cartilages (ULC) with the nasal septum and the excess of ULC are evaluated. The ULC excess is marked to allow the exact removal in form of ellipsis in the longitudinal direction of the cartilage. The ellipsis width is determined according to the structure and the excess of nasal cartilage. ULC is exposed and the ellipsis is dried in the horizontal direction following the lateral projection of the cartilage, at a half distance of its width to prevent from interfering with the nasal valve. The evaluation of the ellipsis size to be dried must be carried out meticulously and carefully in order to avoid stenosis of the nasal valve. The authors operated 25 cases during a period of three years. Results: In all cases the results were satisfactory. No review was needed. Conclusions: This method is a good choice to the traditional techniques in the large dorsum. As for the nasal large middle third, the elliptic removal of the ULCs is a useful option when well indicated. Care must be taken of individuals with the inner nasal valve commitment, which may be aggravated with such maneuver

Localized nasopharyngeal amyloidosis

Introduction: The amyloidosis is a benign deposit disease and may be systemic or localized. It's uncommon when localized in the head and neck. Objective: To present the case of a patient with localized nasopharyngeal amyloidosis and discuss its presentation. Case Report: Male, white, 46-year-old patient with rhinorrhea, aural plenitude and recurrent epistaxis whose amyloidosis diagnosis was carried out through nasal lesion biopsy. The clinical and radiological findings, as well as the primary disease management are discussed. Final Comments: In the absence of a systemic disease, the nasal amyloidosis must be treated in a conservative manner

Chondromyxoid fibroma of the nasal bone

Introduction: Chondromyxoid fibroma is a rare benign tumor that usually occurs in the long bones and rarely affects the sinonasal region. Both clinically and histologically, it is a difficult diagnosis and can be confused with malignant lesions. Objective: To present a case of chondromyxoid fibroma of the nasal bone and discuss its presentation. Case Report: A 48-year-old man with diagnosis of chondromyxoid fibroma of the nasal turbinates with local destruction and extension into the ethmoidal sinus. Final Comments: The complete surgical excision of this type of lesion is extremely important for long term control of the disease due to its high recurrence