UNASSIGNED: We will describe the use of nasolabial Burow\'s advancement flaps (perialar crescentic advancements) to repair multi subunit defects of the nasal sidewall including the adjacent cheek, dorsum, tip, and ala without the need of additional flaps.
UNASSIGNED: This retrospective single centre study analyzed 6 month postoperative photographs using the Manchester Scar scale. The operative technique is described in detail.
UNASSIGNED: Of 355 cases, 336 were available for analysis. The median Manchester Scar scale was 7 for both sidewall defects and multi-subunit defects. There were low rates of infection or necrosis.
UNASSIGNED: With the correct technique, the nasolabial Burow\'s advancement alone is suitable to repair even large multi-subunit defects involving the nasal sidewall, cheek, dorsum, tip, and ala with high-level aesthetic and functional results.

UNASSIGNED: Nasal obstruction after total nasal reconstruction is a serious complication that contributes to breathing difficulty, snoring, and obstructive sleep apnea, which can negatively influence daily activities. However, few treatments have been reported in detail for this condition. Here, a case of nasal vestibular obstruction after total nasal reconstruction that was treated with bilateral superior subcutaneous pedicle nasolabial flaps is reported.
UNASSIGNED: An intranasal stent was used postoperatively for five months to prevent restenosis. Internal stenosis was not noted 25 months postoperatively. The patient could breathe easily through his nose and mouth dryness improved.
UNASSIGNED: The flap is relatively thin, easy to elevate with high flexibility and stable blood flow, and useful for nasal vestibular lining reconstruction.

Reconstruction following excision of skin lesions at the cosmetically sensitive junction between the alar base and upper lip continues to be challenging for surgeons. We describe an advancement flap from the nasolabial fold area to reconstruct such defects. Our case demonstrates a gentleman with a clinically diagnosed BCC between the alar base and upper lip. An advancement flap from the nasolabial area was designed to reconstruct the defect, with two Burrow\'s triangles excised to prevent standing cones. The scar of the two Burrow\'s triangles falls over the nasolabial fold, resulting in the integration of the scar within the natural line. This flap design also maintains of the level of the upper lip, the shape and position of the nostril, and minimises flattening of the philtrum. Excellent cosmetic results were seen six weeks post-op.

The glabrous skin around the nostrils in mammals is called a rhinarium or planum nasale. Rhinarium skin has multiple epidermal domes that are generally assumed to form a tactile surface. The rhinarium is innervated by a branch of the trigeminal nerve which is associated with stimuli such as touch, chemical irritants and temperature. In this study, our aim was to correlate variation in rhinarium skin sensory innervation with different feeding behaviors while also covering a broad systematic spectrum. Using histological and immunohistological methods, we studied skin morphology, nerve fiber density and nerve fiber distribution in the rhinarium epidermal domes of four species: cow, ring-tailed lemur, brown bear, and dog, that all exhibit different feeding behaviors. All species share similar traits in rhinarium skin morphology, but glands were only found in cow rhinarium skin. The most substantial differences were observed in the innervation pattern. Mechanosensory skin organs were found only in the ring-tailed lemur. Dog epidermal domes possess a pronounced central dermal papilla containing a nerve bundle in its top, close to the skin surface. The abundance of free epidermal nerve fibers in epidermal domes of all species, suggest that the rhinarium skin is a sensory surface, that can be used to detect fine touch, chemical irritants or temperature. In the species where the whole epidermal dome was examined, the intraepidermal nerve fiber density is higher in the central part of the domes. The nerve distribution and the central positioning of a single gland duct in cow and the dermal papilla top organ in dog indicates that each epidermal dome can be considered a functional unit. The observed differences in innervation hint at different sensory functions of rhinaria in mammals that may be correlated to feeding behavior.

BACKGROUND: The advent of social media has influenced the relationship between aesthetic surgeons and their patients, as well as the motivations of such patients to seek cosmetic surgery.
OBJECTIVE: To determine how the cephalometric proportions of modern social media models fit with historical canons of beauty.
METHODS: Frontal and lateral photographs of 20 high-influence female Instagram models were obtained and evaluated for cephalometric measures. The means of these measures were compared with previous reports in the literature.
RESULTS: Cephalometric measurements of social media models were in agreement with historical ideals of beauty for Nostril axis (120.7°), Goode\'s ratio (0.6), Nasofacial angle (35.7°), Nasofrontal angle (130.9°), and the horizontal thirds. Results were discrepant from historical ideals for the Nasolabial angle (82.6°) and the vertical facial fifths.
CONCLUSIONS: Cephalometric measurements of social media models in the digital age closely resemble the ideal values proposed by previous authors. Due to a preference for larger or altered lip profiles, nostril axis is a more reliable measure of nasal tip rotation than nasolabial angle.

BACKGROUND: Nasolabial cysts are rare, non-odontogenic, soft-tissue cysts that develop between the upper lip and nasal vestibule with an overall incidence of 0.7% out of all maxillofacial cysts. The predominant presentation of a nasolabial cyst is a painless localized swelling with varying degrees of nasal obstruction. Several treatment modalities have described in the management of the nasolabial cyst. In this paper, we present a case of a nasolabial cyst in a 44 years old man with discussions of the treatment modalities in the lights of the literature.
METHODS: We present a case of a nasolabial cyst in a 44-year-old man that slowly increased in size through a period of 3 years, with associated mild pain and nasal obstruction. It had caused a mass effect upon the maxilla, resulting in scalloping. The cyst was excised entirely with no evidence of recurrence at the two months follow up.
CONCLUSIONS: The nasolabial cyst is a rare soft-tissue cyst. Complete surgical excision using an open approach performed to our case, which considered with the complete endoscopic removal of the best treatment for the nasolabial cysts with a rare recurrence rate.

OBJECTIVE: To (a) assess nasolabial outcomes across four main cleft subgroups, (b) assess agreement using a categorical and a continuous scoring measure and (c) compare outcomes to international studies.
UNASSIGNED: Analysis of 470 images of which 218 was unilateral cleft lip and palate (UCLP), 128 unilateral cleft lip (UCL), 90 bilateral cleft lip and palate (BCLP) and 34 bilateral cleft lip (BCL). Images were taken around five (n = 279) and eight-ten (n = 191) years of age.
METHODS: Cropped images were assessed using the Asher-McDade (AM) and a 100 mm visual analogue scale (VAS) by a panel of six raters. Scoring was undertaken for vermillion border and nasal form, symmetry and profile. Analysis was undertaken for each subscore, a total score with sensitivity analysis using a total score based on the subscores for each patient. AM intra- and inter-rater reliability was assessed using weighted kappa and for the VAS components reliability was assessed using Pearson correlation.
RESULTS: The AM intra-rater reliability was moderate/substantial, whilst inter-rater reliability was fair. The VAS intra-rater correlations were high, and inter-rater correlations were moderate. Better outcomes were found with cleft lip (CL) vs cleft lip and palate (CLP). No differences were found for sex, ethnicity, age and cleft laterality (unilateral). The AM found no difference between unilateral or bilateral. The VAS found bilateral scored worse than unilateral for both CL and CLP.
CONCLUSIONS: The nasolabial outcomes differ by cleft type. The correlation was relatively high for the VAS whilst the AM had relatively poor reliability.

Objective:To explore the application of nasolabial fold wrapped perforator flap in one-stage repair of nasal alar full-thickness defects after external nasal tumor resection.Method:Fifteen csaes of alar full-thickness defects after external nasal tumor resection were repaired with the nasolabial fold wrapped perforator flaps in a one-stage procedure. We detected the blood vessel distribution and exit of the blood vessel with Doppler Ultrasonography before these surgeries，and designed the nasolabial fold wrapped perforator flap according to the area and size of nasal alar defects． The flap with reasonable thickness was able to repair the both sides of defect after being trimmed properly. Meanwhile，the flap could be folded to form a local flap covered or lined with skin. We rotated and transferred the flap to repair nasal alar defect． Result:All the flaps survived and all donor sites healed primarily．After 3 to 36 months of follow-up,the color，texture and thickness of the flaps was similar to those of recipient sites．The scar in donor site was minor．There was little scab skin in the nasal cavity. The cosmetic results was satisfactory. Conclusion:The nasolabial fold wrapped perforator flap has the advantages of reliable blood supply,long pedicle flap,proper thickness,outside the skin and the inner lining. The cosmetic appearance of nose is satisfactory.There was little scab skin in the nasal cavity. Also the sensory function of the external nose was retained. The nasolabial fold wrapped perforator flap technique provides an ideal reconstructive option for the nasal alar full-thickness defect repair at one-stage after tumor resection.

Reconstruction of an entire alar wing is a frequently encountered reconstructive challenge in onco-dermatologic surgery. The aim of this technical note was to describe a surgical technique total for reconstruction of the alar wing, with a modified nasolabial flap with an inferior pedicle associated with a cartilaginous graft. This rapid procedure seems to be a well alternative for elderly people and patients who do not want a forehead flap. The aesthetic and functional outcomes of the donor and recipient sites were satisfactory.

To define the preferred nasolabial angle measurement in Middle Eastern population. An observational study was conducted from January 2012 to January 2016 at the Department of Otolaryngology, Head and Neck Surgery, King Abdulaziz University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. A total of 1027 raters, 506 males, and 521 females were asked to choose the most ideal nasolabial angle for 5 males and 5 females lateral photographs whose nasolabial angle were modified with Photoshop into the following angles (85°, 90°, 95°, 100°, 105°, and 110°). Male raters preferred the angle of 89.5° ± 3.5° (mean ± SD) for males and 90.8° ± 5.6° for females. While female raters preferred the angle of 89.3° ± 3.8° for males and 90.5° ± 4.8° for females. ANOVA test compare means among groups: p: 0.342, and there is no statistically significant difference between groups. The results of our study showed an even more acute angles than degrees found in the literature. It shows that what young generation in our region prefers and clearly reflects that what could be explained as under rotation of the nasal tip in other cultures is just the ideal for some Middle Eastern population.