Daniel R K
Division of Plastic Surgery, University of California at Irvine, Newport Beach, USA.
Plast Reconstr Surg. 1999 Apr;103(5):1503-12. doi: 10.1097/00006534-199904050-00023.
Tip suture techniques have proven effective in managing many secondary tip deformities. The open approach is used in most cases because it allows analysis and utilization of the alar remnants. If the alar rim strip is intact and not deformed, then a three-stitch technique (strut, domal creation, and domal equalization) is used. If the domes were previously transected, they are repaired and an attempt is made to shape them with sutures. If sutures are ineffective or the domes are deformed, judicious excisions and tip-shaping sutures are employed to achieve an aesthetic "tip shape," as expressed through the overlying skin. Removal of sutures from previously sutured tips has proven effective in the columella and infralobular area, ineffective in the supratip midline, and unpredictable over the domal segment. Overall, tip suture techniques should be considered in secondary tip deformities whenever the alar cartilage remnants permit.
鼻尖缝合技术已被证明在处理许多继发性鼻尖畸形方面是有效的。大多数情况下采用开放式入路，因为它允许对鼻翼残余部分进行分析和利用。如果鼻翼缘条完整且未变形，则采用三针技术（支柱、穹窿形成和穹窿均衡）。如果穹窿先前已横断，则对其进行修复，并尝试用缝线对其塑形。如果缝线无效或穹窿变形，则采用明智的切除术和鼻尖塑形缝线，以通过覆盖其上的皮肤实现美观的“鼻尖形状”。事实证明，从先前缝合的鼻尖去除缝线在鼻小柱和小叶下区域是有效的，在鼻尖中线以上无效，在穹窿段则不可预测。总体而言，只要鼻翼软骨残余允许，继发性鼻尖畸形应考虑采用鼻尖缝合技术。
