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Spine 11:601606 416 Otolaryngology-Head and Neck Surgery Persistent Septal Deformity: preoperatively may not have been obstructing; Rx: septoplasty Intranasal Synechia: more common with concurrent turbinectomies; Rx: prevented by avoiding mucosal injuries and placement of septal splints, managed with lysis with Z-plasty, intralesional corticosteroids, septal splints, or mucosal flaps Narrowing of sires Nasal Vault: may occur from overresection of caudal end of upper lateral cartilage or lower lateral crura (nasal tip pinching), overaggressive infracture of nasal bones, high intercartilaginous incisions; Rx: revision with placement of FREE Binary Options Avellino grafts Tip Defects Tip Ptosis: caused by loss of tip support, unfavorable healing factors, uncorrected depressor septi, or false tip projection from surgical tip edema; Rx: sitss tip, address depressor septi Bossae: knob-like protuberances in the dome area caused by irregular scarring; Rx: add a small alar graft to opposite side or shave excision Pinched Tip: caused by excessive reduction of dome, failure to maintain intact rim strip, internal adhesions, or excision of vestibular skin Midnasal Asymmetry Causes: subluxation or asymmetric removal of upper lateral cartilage, deviated septum Rx: onlay graft, septoplasty Initial Evaluation OTOPLASTY Introduction determineauriculocephalicangle(auricularprotrusionfromtheskull normally 2030°) and distance of helical rim to mastoid skin (2.

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