DR. MENWAL HARB
American Crescent Health Care Center, Abu Dhabi, UAE
Biography
Dr. Menwal Abdo Harb, ENT Specialist, Syria, American Crescent Health Care Center, UAE , MD: Faculty of Medicine, Damascus University, Damascus, Syria 2002. ENT Specialist: Ministry of Health, Damascus Syria, 2007._ Arab Board Certified of Otolaryngology Head And Neck Surgery, Arab Board Council, Damascus Syria2008. Fellow of the European Board Of Otolaryngology Head and Neck Surgery, Nov 2018, Vienna, Austria. Licensed to practice as a Senior ENT Specialist, Ministry of Health, Syria, Private Clinic and Private Hospital to 2012.
Licensed to Practice as a Senior ENT Specialist, HAAD(Health Authority of Abu Dhabi), American Crescent Health Care Center, Abu Dhabi, to this date. Attendance and hand work of 2nd Aesthetic and Functional Septorhinoplasty, Lectures and Workshop, Dubai 2014. Attendance and hand work of 2nd Intensive Snoring and Sleep Apnea, Lectures and Workshop, Dubai 2014. Attendance and hand work of 3rd Intensive Snoring and Sleep Apnea, Lectures and Workshop, Dubai 2015.Well experienced in clinical and diagnostic procedures, hearing tests, and Vestibular tests.Well experienced in emergency cases of otolaryngology, Head and Neck Surgery ( Epistaxis, Nasal Fractures, Foreign Body Aspiration).Well experienced in Rhinoplasty, Functional Endoscopic Sinus Surgery, Microscopic ear Otologic Surgery.Interested in clinical researches, updated guidelines, Workshops, and Conferences.
Abstract
The abstract:
A 30 years old male patient presented with a nasal scar at the junction between the columella and the nasal tip, after one year of exposure to a vehicle accident with an inappropriate suturing, I found that the scar repositioning is the best technique for this patient, so I decided to do external approach Rhinoplasty with changing the position of the new scar to a lower position.
Key words:
Scar revision, external approach rhinoplasty, facial wounds.
The introduction:
The healing of the wound results in a scar, the appearance of the scar depends on the wounding mechanism, wound location, wound tension, initial treatment, infection, and dehiscence.(1).
Successful scar revision begins with a precise analysis of both the scar and the patient expectations. The surgeon should educate the patient on the true realistic goal of surgery, which is to modify the scar to a point of maximized camouflage within the natural shadows, lines and borders tht exist within the head and neck.(2).
The case presentation:
A 30 years old male patient presented with a nasal scar at the junction between the columella and nasal tip at the left side of the nose, after one year of a vehicle accident, with a left side nasal obstruction.
No other complaints, no medical history, no surgical history.
The physical examination:
An external nasal scar, deviation of the nasal axis to the right side,
left septal deviation, the remainder examination is within normal.The goal is to remove the scar and improve the nasal breathing.
The plan: External approach rhinoplasty, which is discussed with the patient and greed.
The surgical technique:
The first step is the scar removal, after that I completed the surgery as a traditional external approach rhinoplasty with septoplaty, hump grasping, bilateral lateral osteotomies, tip plasty, then I retracted the nasal skin and stitched it at the columella at the lowest possible position without any tension at the sutures and wound edges, which was at the middle of the columellar length, then I trimmed the skin edges to create the nostrils edges.
The result and follow up: The stitches and the nasal splint are removed one week after the surgery, and the patient returned to his normal daily activities after two weeks.
The follow up after six months: The patient is fully satisfied of the result, functionally and aesthetically,
The conclusion:
The best technique of scar revision is the technique that gives us the best camouflage, by doing the incisions parallel to or in relaxed skin tension lines, at the junction of facial aesthetic units, within margins of orifices, or at the edge of hair line, and staged procedures are often necessary to accomplish the optimal result.