Davis Richard E, Raval Jeffrey
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, University of Miami School of Medicine, Miami, FL, USA.
Arch Facial Plast Surg. 2003 Sep-Oct;5(5):384-91. doi: 10.1001/archfaci.5.5.384.
To evaluate power-assisted bone removal in cosmetic rhinoplasty.
Nonrandomized, nonblinded, retrospective evaluation of consecutive case series.
Academic facial plastic surgery practice.
Power-assisted bone removal in 105 consecutive rhinoplasties requiring nasal bone reduction.
Subjective evaluation by patient and surgeon.
Of the 105 patients undergoing power-assisted bone removal, 102 obtained satisfactory refinement of the nasal dorsum after 1 operation. Three patients required surgical revision of the nasal dorsum following power-assisted bony hump reduction. Of these, 2 required surgical revision for delayed bone regrowth, while the remaining patient required surgical treatment of a persistent bony hump. Ultimately, all 105 patients achieved satisfactory surgical results. No other surgical complications were observed.
Power-assisted bone removal is a useful adjunct for bone removal in cosmetic rhinoplasty. This study confirms the previously reported advantages of powered instrumentation for patients with small bony humps or modest bony asymmetries. Moreover, because powered instrumentation is comparatively atraumatic, it may be preferable for use in nasal bones previously weakened by trauma, aging, or prior nasal surgery. Finally, because the powered nasal rasp permits rounding of the bone edges, the characteristic widening associated with flat hump reduction is reduced, and the need for aggressive sidewall infracture is diminished. Complications associated with power-assisted bone removal were rare.
评估在美容隆鼻术中使用动力辅助去骨技术。
对连续病例系列进行非随机、非盲法回顾性评估。
学术性面部整形手术机构。
在105例连续的需要鼻骨缩小的隆鼻术中采用动力辅助去骨技术。
患者和外科医生的主观评估。
在105例行动力辅助去骨的患者中，102例在1次手术后鼻背得到了满意的改善。3例患者在动力辅助去除鼻骨驼峰后需要对鼻背进行手术修复。其中，2例因骨再生延迟需要手术修复，而其余1例患者需要对持续存在的鼻骨驼峰进行手术治疗。最终，所有105例患者均取得了满意的手术效果。未观察到其他手术并发症。
动力辅助去骨是美容隆鼻术中去骨的一种有用辅助手段。本研究证实了先前报道的动力器械对于小鼻骨驼峰或轻度鼻骨不对称患者的优势。此外，由于动力器械造成的创伤相对较小，对于先前因外伤、衰老或既往鼻部手术而变薄弱的鼻骨，可能更适合使用。最后，由于动力鼻锉可使骨边缘变圆，与扁平驼峰缩小相关的特征性变宽减少，且减少了积极进行侧壁骨折的必要性。与动力辅助去骨相关的并发症很少见。
