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The following unusual case seems of sufficient interest to deserve publication: Patient. —Mrs. W., Mexican, 30 years of age, came to me Aug. 1, 1904, complaining of a "sore nose." History. —About a year before she accidentally struck her nose violently against a door. There was no hemorrhage, nor even broken skin, but the blow was a severe one, and her nose had troubled her ever since, hurting severely one week, and appearing to get almost well another. Examination. —Inspection showed nothing abnormal except a little redness and swelling about the lower left ala. On palpating the nose lightly with my finger there was a most peculiar sensation of something slipping or giving way beneath. This also caused some pain. I diagnosed dislocation of the left lower lateral cartilage of the nose. Ordinarily there was no displacement because the elasticity of the surrounding tissues held it in place. Yet it

This year marks the 20th anniversary of Dr Jack Anderson's presentation of the Tripod Concept. This representation of the two lateral crura and combined mesial crura as the three legs of a tripod has been a key concept (perhaps the key concept) to explain nasal tip dynamics over the last 20 years. Dr Anderson's original explanation is still valid and is used today to explain the mechanics of the various tip rhinoplasty techniques. Herein, we reprint the key aspects of Dr Anderson's classic article on its 20th anniversary in honor of his contribution. 1 THE DYNAMICS OF RHINOPLASTY It has been found helpful in teaching to liken the lower lateral cartilage complex that forms the skeleton of the nasal tip to a tripod, the conjoined mesial crura being one leg and the lateral crura forming the other two. The legs of the tripod are not of equal length, and they

Composite grafts from the postauricular area can be used to repair one side of a septal perforation. A sliding bipedicle flap is used from the floor of the nose to close the opposite side of the perforation. A good result with this technique would be expected since it is a well-known fact that composite auricular grafts have a high success rate when used to repair alar defects. The case histories presented illustrate variations of the technique. In the first case, the graft is inserted without an incision of the nasal alar angle. In the second case, the nasal alar angle is incised to increase visibility. The third case utilizes an auricular composite graft to replace the lower lateral cartilage and a portion of the septum.