Williams EF 3rd, Sam Lam , MD
FACIAL PLASTIC SURGERY/VOLUME 18, NUMBER 4 2002
Above all facial plastic procedures, rhinoplasty is the most intimately tied with the otolaryngologic field. The historical roots of modern aesthetic rhinoplasty may be traced back to the late 19th century with the pioneering work of John Orlando Roe. Roe accomplished the remarkable feat of the first entirely intranasal rhinoplasty to correct what he termed the “pug-nosed deformity” in 1881. Prior to Roe’s seminal thesis, Dieffenback among others performed his cosmetic nasal work via large vertical incisions across the external nose, leaving noticeable scarring and disfigurement. Roe’s innovative techniques antedated even that of Jacques Joseph by 11 years. Besides his contribution to rhinoplasty, Roe, an otolaryngologist, had already published numerous scholarly articles (over 30) on various head and neck ailments, including many of functional nasal problems.
The cleft-lip nasal deformity has a long history of many failed attempts due to the complexity of the problem. Besides all the orthognathic, otolgic, and psychological issues attendant to the cleft-lip patient, the surgeon must encounter a varied anatomy (depending on the extent and bilaterality of the disorder) and must individualize his approach perhaps more so than with traditional aesthetic rhinoplasty. Dr. Skyes is a renowned contributor to the field of cleft-lip nasal surgery and has written a masterful dissertation on the subject in this issue.
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odalities: A Systematic Approach