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巨乳症及上外侧蒂乳房缩小成形术后乳头乳晕复合体感觉的计算机辅助评估:一项统计分析

Computer-assisted evaluation of nipple-areola complex sensibility in macromastia and following superolateral pedicle reduction mammaplasty: a statistical analysis.

作者信息

Santanelli Fabio, Paolini Guido, Bittarelli Delio, Nofroni Italo

机构信息

Rome, Italy From the Plastic Surgery Unit, Sant'Andrea Hospital, Second School of Medicine, and Department of Experimental Medicine and Pathology, First School of Medicine, University of Rome "La Sapienza."

出版信息

Plast Reconstr Surg. 2007 May;119(6):1679-1683. doi: 10.1097/01.prs.0000258828.84107.59.

Abstract

BACKGROUND

The authors performed a prospective study quantifying nipple-areola complex sensibility by computer-assisted neurosensory testing in breast hypertrophy before and after superolateral breast reduction.

METHODS

A superolateral pedicle breast reduction was performed on 30 macromastia patients. The mean age of the patients was 46 years. The cup sizes of the patients were as follows: D, 14 patients; E, 12 patients; and EE, four patients. Ptosis was 3 degrees in 12 and 4 degrees in 18; nipple elevation ranged from 4 to 18 cm; glandular resection ranged from 379 to 1850 g. Static and moving one- and two-point discrimination was tested preoperatively and 6 months postoperatively at the nipple-areola complex, evaluating the impact of breast hypertrophy (D versus E and EE cups), nipple elevation (<9 cm versus > or =9 cm), and glandular resection (<900 g versus > or =900 g).

RESULTS

Statistical analyses revealed preoperatively significant higher pressure thresholds in the nipple-areola complex of larger versus smaller hypertrophies and in the nipple of longer nipple-areola complex transposition breasts for static and moving one-point discrimination. Postoperatively, worsening of sensibility was more significant in the nipple-areola complex of smaller versus larger hypertrophies and of shorter versus longer nipple-areola complex transposition breasts for moving one-point discrimination.

CONCLUSIONS

This study confirms that macromastia patients present a reduced breast sensibility, which is not necessarily worsened by reduction mammaplasty. After reduction mammaplasty with the superolateral pedicle technique, nipple-areola complex sensibility might be slightly reduced, which is less detectable in large-breast hypertrophy because of lower preoperative levels of sensibility and less of a postoperative decrease.

摘要

背景

作者进行了一项前瞻性研究,通过计算机辅助神经感觉测试对巨乳症患者在乳房上外侧缩小术前后的乳头乳晕复合体感觉进行量化。

方法

对30例巨乳症患者实施乳房上外侧蒂缩小术。患者平均年龄46岁。患者的罩杯尺寸如下:D罩杯14例;E罩杯12例;EE罩杯4例。乳房下垂12例为3级,18例为4级;乳头抬高范围为4至18厘米;腺体切除量范围为379至1850克。术前及术后6个月在乳头乳晕复合体处测试静态和动态单两点辨别觉,评估巨乳症(D罩杯与E罩杯和EE罩杯)、乳头抬高(<9厘米与≥9厘米)以及腺体切除量(<900克与≥900克)的影响。

结果

统计分析显示,术前对于静态和动态单两点辨别觉,较大与较小巨乳症患者的乳头乳晕复合体以及乳头乳晕复合体移位距离较长的乳房乳头处的压力阈值显著更高。术后,对于动态单两点辨别觉,较小与较大巨乳症患者以及乳头乳晕复合体移位距离较短与较长的乳房的乳头乳晕复合体处感觉恶化更为显著。

结论

本研究证实巨乳症患者存在乳房感觉减退,而乳房缩小整形术不一定会使其恶化。采用乳房上外侧蒂技术进行乳房缩小整形术后,乳头乳晕复合体感觉可能会稍有降低,由于术前感觉水平较低且术后降低幅度较小,在大乳房巨乳症中这种降低不太明显。

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