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Alar cartilage cephalic malposition was first described as a parenthesis-shaped deformity by Sheen. The aim of this study was to analyze the results of treatment by caudal rotation of the lateral crus for this deformity. Method: A retrospective study was conducted with 49 cases, operated on between July 2011 and January 2013 at the 2nd Infirmary of the Santa Casa da Misericordia in Rio de Janeiro and at a private clinic. Results: Most of the patients (76% of cases) had a severe form of this deformity. All others presented with a moderate form (24% of cases). Fifty seven percent of the patients (57%) had a “boxy tip” and an initial alar pinching, 61% showed alar retraction and 8%, external valve collapse. The “boxy tip” was corrected in 100% of cases; initial alar retraction, 97%; alar pinching, 96%; and external valve collapse, 100%. The 3 cases of unilateral relapse were corrected by the same technique during a second rhinoplasty. Conclusions: This study shows that caudal rotation of the lateral crus can treat the deformity described by Sheen with a small number of relapses and without serious complications.

Parenthesis-shaped deformity of the alar cartilages: a retrospective analysis of 49 cases of treatment by caudal rotation of the lateral crura