Arslan Emrah, Aksoy Alper
Department of Plastic and Reconstructive Surgery, Mersin University, Medical School, Mersin, Turkey.
Laryngoscope. 2007 Jun;117(6):990-6. doi: 10.1097/MLG.0b013e31805366ed.
Dorsal hump reduction is a critical step in rhinoplasty. Most of the reasons behind revisional procedures are related to incorrect hump reduction.
The authors used a modified dorsal hump reduction method in their primary cases, the steps of which are as follows: 1) dissection of the nasal vault; 2) bilateral submucoperichondrial dissections to free the cartilaginous septum; 3) separation of the upper lateral cartilages from the cartilaginous septum; 4) partial dissection of the upper lateral cartilages from the inner surfaces of the nasal bones bilaterally; 5) separation of the bony septum from the nasal bones bilaterally; 6) reduction of the partially isolated nasal bones; 7) en bloc cartilaginous and bony septum removal. The authors have operated on 68 primary cases over a 2 year period (30 mo).
In the great majority of cases, the results were satisfactory. No revisions were performed in this patient group.
This method is a good alternative to traditional techniques in noses with a high and narrow roof, thin skin, and weak middle nasal vault. Revision could be performed more easily when required. Initially, wide noses may not seem good candidates for this procedure; however, careful case-based preoperative planning may overcome this difficulty.
驼峰鼻矫正术是鼻整形术中的关键步骤。修复手术背后的大多数原因都与不正确的驼峰鼻矫正有关。
作者在其初次手术病例中采用了改良的驼峰鼻矫正方法，步骤如下：1）鼻背解剖；2）双侧黏膜下软骨膜下剥离以游离鼻中隔软骨；3）将上外侧软骨与鼻中隔软骨分离；4）双侧从上外侧软骨内表面部分剥离鼻骨；5）双侧将骨性鼻中隔与鼻骨分离；6）对部分分离的鼻骨进行截骨；7）整块切除软骨性和骨性鼻中隔。作者在两年时间（30个月）内对68例初次手术病例进行了手术。
绝大多数病例效果满意。该患者组未进行修复手术。
对于鼻背高且窄、皮肤薄且鼻中段薄弱的鼻子，该方法是传统技术的良好替代方法。必要时修复更容易进行。起初，宽鼻似乎不太适合该手术；然而，基于病例的仔细术前规划可能会克服这一困难。
