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Nasal Dermoplasty for Recurrent Polyposis (NDRP)

Proposed technique for reducing the tendency for recurrence of nasal polyps (G Anastasopoulos, G Grigoriadis and S Papoutsi. Modified nasal dermoplasty technique for treatment of recurrent polyposis: preliminary results. The Journal of Laryngology & Otology, Published online by Cambridge University Press: 26 April 2013)

1. Starting sphenoethmoidectomy on the left. 2. Removal of polyps and cells from the middle nasal meatus.
3. Removal of a maxillary sinus cyst. 4. Entering the posterior ethmoids.
5. Locating the superior nasal concha. 6. Posterior to anterior ethmoidectomy.
7. Correction of septal deviation. 8. Right ethmoidectomy.
9. The right superior nasal concha. 10. Entering agger nasi.
11. Starting the process of flattening the fovea ethmoidalis and lamina papyracea. 12. Removal of the polypoid mucosa with Weil Blakesley forceps.
13. or with a Cottle elevator. 14. Trying to remove mucosa around the anterior ethmoid artery.
15. Removal of bony septa with a diamond burr. 16. Flattening the lamina papyracea.
17. The removal of the mucosa probably implies the removal of the periosteum also. 18. A bleeding point behind the posterior ethmoid artery.
19. General view of the left nasal cavity. 20. Right nasal cavity. Starting flattening process.
21. Elevation of the mucosa with a curette. 22. Removal of bony septa with a diamond burr.
23. Tissue removal with a Weil Blakesley forceps 24. Flattening the lamina papyracea.
25. A bleeding point in front of the sphenoid sinus. 26. Haemostasis with surgicel.
27. Continue smoothing the bone projections. 28. Covering the cavity until the graft insertion.
29. Suture to fixate the middle turbinates. 30. Passing the suture through the right concha.
31. Tying the suture in the left nasal cavity. 32. Preparing the area to take the graft.
33. Taking the graft. 34. Split-thickness skin grafts.
35. Preparation to insert the graft into the left nasal cavity. 36. Removing tamponade and surgicel.
37. Insertion of the graft with the paper. 38. Trying to apply the graft into the surgical cavity and .
39. detach it from the paper. 40. The process is almost complete.
41. Removing the paper. 42. Final view. No packing is needed.
43. Removing the packing from the right nasal cavity. 44. Insertion of the graft with the paper.
45. Pressing the graft for application on the surgical cavity. 46. Detaching the paper (middle concha).
47. Detaching the paper (lamina papyracea). 48. Detaching the paper (sphenoid sinus).
49. Almost complete detachment of the paper. 50. Removing air between the graft and the bone.
51. Final view. No packing is needed. 52. The skin graft one month after the operation.