Kara Cüneyt Orhan, Kara Inci Gökalan, Topuz Bülent
Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
J Oral Maxillofac Surg. 2005 Aug;63(8):1088-90. doi: 10.1016/j.joms.2005.04.008.
The study goal was to determine whether creating a subperiosteal tunnel before lateral osteotomy had an effect on postoperative periorbital edema, ecchymosis, and subconjunctival ecchymosis.
Eighteen consecutive patients who underwent septorhinoplasty were included in the study. In all patients lateral osteotomies were carried out bilaterally, after creating a subperiosteal tunnel on a randomly chosen side and without creating a subperiosteal tunnel on the other side. The patients were seen on the second postoperative day, and a different surgeon who was unaware of the side with the periosteal tunnel determined the side of the face with more edema and ecchymosis. Subconjunctival ecchymosis was evaluated and recorded, as well.
Creating subperiosteal tunnels before lateral osteotomy statistically increased periorbital ecchymosis. Although there was no statistically significant difference, creating subperiosteal tunnels also increased development and severity of subconjunctival ecchymosis and edema.
We suggest performing lateral osteotomy without creating subperiosteal tunnels.
本研究的目标是确定在外侧截骨术前创建骨膜下隧道是否对术后眶周水肿、瘀斑和结膜下瘀斑有影响。
本研究纳入了18例连续接受鼻中隔成形术的患者。在所有患者中，双侧均进行外侧截骨术，一侧随机选择创建骨膜下隧道，另一侧不创建骨膜下隧道。术后第二天对患者进行检查，由一位不知道哪一侧有骨膜下隧道的不同外科医生确定面部哪一侧水肿和瘀斑更严重。同时对结膜下瘀斑进行评估和记录。
外侧截骨术前创建骨膜下隧道在统计学上增加了眶周瘀斑。虽然没有统计学上的显著差异，但创建骨膜下隧道也增加了结膜下瘀斑和水肿的发生及严重程度。
我们建议在不创建骨膜下隧道的情况下进行外侧截骨术。
