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Background: The dorsal roof flap (DRF) technique was developed as a modification of the retractable roof method, which is a variant of dorsal preservation (DP)., Objective: The paper aims to present new results of the DRF technique and dorsal deformity analysis created for the technique., Methods: A total of 57 primary rhinoplasty patients treated with DRF technique between 2022-2023 years were included in the study. A dorsal deformity classification based on the anticipated amount of dorsal reduction, nasal bone shape, and hump content was used. According to the classification, the noses were categorized into 3 types. All data were obtained from patient records, computed tomography views, and pre-and postoperative photographs. Aesthetic and functional results were assessed pre-and postoperatively using a visual analog scale (VAS) (0-10, 0 points means very poor)., Results: The mean follow-up period was 10.1 ± 3.9 months. 23 cases were type 1, 14 were type 2, and 20 were type 3. The anticipated amount of dorsal reduction in type 1 was 2-4 mm, 5-7 mm in type 2, and 8-10 mm in type 3 deformity. Of the total, 27 cases had a V-shaped nasal bone and 30 had an S-shaped. The hump composition was cartilaginous in 13 cases and bone and cartilage in 44 cases. Pre- and postoperative aesthetic and functional VAS scores were significantly different (p ≤ 0.001). No complications and therefore no revisions were observed during the follow-up period., Conclusion: It is a versatile method to reshape the nasal dorsum and minimize the revisions associated with dorsal preservation when used in appropriate cases., (Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: Preservation rhinoplasty (PR) is considered to be an innovative approach with high patient satisfaction. However, little is known about its functional outcomes and radiological analyses., Patients and Methods: In this prospective clinical study, 30 patients (20 female and 10 male patients, mean age 30.7 ±9.8 years) were operated on between 2017 and 2021. Radiological assessment was evaluated by cone beam computed tomography before surgery and at final follow-up. Patient assessment regarding their outcome was assessed at final follow-up using a validated questionnaire (rhinoplasty outcomes evaluation questionnaire = ROE)., Results: After a mean follow-up of 8.4 ± 5 months (range = 1 - 18 months), radiological analyses denoted an overall improved internal nasal valve (INV) angle after surgery (preoperative = 20.77° ± 3.2° vs. postoperative = 21.82° ± 5.7°, p = 0.18). Those results are in accordance with an overall high patient satisfaction for both function and aesthetics (ROE score 18.4 ± 4.3)., Conclusion: Our study showed a preserved and widened INV angle after PR, along with high patient satisfaction., Level of Evidence: III., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest, (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Following two cases of anaphylactoid reactions during anaesthesia, immunoallergological investigations showed up the responsibility of droperidol, which probably acted by way of an anaphylactic mechanism. In both cases, there were no cardiovascular signs, the main clinical symptom being bronchospasm. The exceptional nature of allergic accidents due to neuroleptic drugs, as opposed to extrapyramidal phenomena, must be underlined. However, these reactions should cast doubts on the safety and usefulness of neuroleptanalgesia.

Four patients were studied following an anaphylactoid accident occurring during general anaesthesia. Histamine release was assessed on clinical signs, basophil degranulation and, in one case, an early serum histamine peak. Past medical history revealed previous allergies in all cases. An immunological study showed that IgE, CH50, C3 and C4 serum levels were within the normal range. Skin reactivity to histamine was normal in all but one case. In every case, one of the drugs used during the anaesthetic gave a positive skin test and was considered as the causative agent. There were discrepancies between the in vitro and in vivo tests of basophil degranulation, a second drug being positive in one case, and several drugs inducing abnormal degranulation reactions in the other cases. The drugs considered as involved in these accidents are noteworthy: suxamethonium (two cases), fluid gelatin (Plasmion) and droperidol. The results are discussed by the authors.