HYALURONIDASE IN RHINOPLASTY

Abstract
DURING the last few years there has been a widespread increase in the clinical use of hyaluronidase, the specific enzyme now generally conceded to be the "spreading factor" of Duran-Reynals1 and McClean.2 Various authors have reported its effectiveness in facilitating the absorption of fluids by hypodermoclysis3 and in effecting better local anesthesia in general surgery and dentistry4 and its effectiveness in ophthalmology5 and other varied clinical applications.6 We therefore decided to explore its possibilities in the field of rhinoplastic surgery. Hyaluronic acid, a chemical gel, functions in tissues of the body as a cement substance between cells, thus acting as a barrier to the diffusion of tissue fluids. Hyaluronidase is the specific enzyme which hydrolyzes and depolymerizes hyaluronic acid,7 with the resultant lessening of the viscidity of the gel and consequent facilitation of diffusion of tissue fluids: The rate of diffusion is proportionate to the amount of enzyme available, and