Janis Jeffrey E, Trussler Andrew, Ghavami Ashkan, Marin Vincent, Rohrich Rod J, Gunter Jack P
Dallas, Texas From the Department of Plastic Surgery, The University of Texas Southwestern Medical Center.
Plast Reconstr Surg. 2009 Jun;123(6):1830-1841. doi: 10.1097/PRS.0b013e3181a65ba2.
Lower lateral crural deformities are common problems in rhinoplasty. The shape and position of the lower lateral crura directly influence the alar contour and external valve function. This study reviews an extensive experience with the lower lateral crural turnover flap, which represents a versatile and reproducible technique for correction of lower lateral crural deformities and improvement of external valve function.
A retrospective review of our experience with the lateral crural turnover flap in consecutive primary (n = 21), secondary (n = 2), and tertiary (n = 1) open rhinoplasties was conducted to evaluate the indications, contraindications, and long-term outcomes of this technique. Patient case examples are used to illustrate this technique and its results.
The lower lateral crural turnover flap is beneficial for deformities, weakness, and collapse of the lower lateral crura. It can also be used to improve lower lateral crural strength during tip reshaping. It is contraindicated when there is insufficient width of the lower lateral crura. A lower lateral crural turnover flap can complement other external valve and alar arch supporting techniques, such as placement of alar contour grafts and/or alar batten grafts. The shape and position of the lower lateral crural turnover flaps have had long-lasting results (>1 year) after open rhinoplasty.
The lower lateral crural turnover flap is a useful and reproducible technique in rhinoplasty with enduring results. The use of adjacent cartilage provides a local source of viable tissue to correct and support the lower lateral crura in both primary and revision rhinoplasty.
鼻小柱下外侧畸形是鼻整形术中常见的问题。鼻小柱下外侧的形状和位置直接影响鼻翼轮廓和鼻外阀功能。本研究回顾了大量使用鼻小柱下外侧翻转皮瓣的经验，该技术是一种通用且可重复的技术，用于矫正鼻小柱下外侧畸形并改善鼻外阀功能。
对我们在连续的初次（n = 21）、二次（n = 2）和三次（n = 1）开放式鼻整形术中使用鼻小柱外侧翻转皮瓣的经验进行回顾性分析，以评估该技术的适应证、禁忌证和长期效果。通过患者病例来阐述该技术及其效果。
鼻小柱下外侧翻转皮瓣对鼻小柱下外侧的畸形、薄弱和塌陷有益。它还可用于在鼻尖整形过程中增强鼻小柱下外侧的强度。当鼻小柱下外侧宽度不足时为禁忌证。鼻小柱下外侧翻转皮瓣可补充其他鼻外阀和鼻翼弓支撑技术，如鼻翼轮廓移植和/或鼻翼条移植。开放式鼻整形术后，鼻小柱下外侧翻转皮瓣的形状和位置具有持久的效果（>1年）。
鼻小柱下外侧翻转皮瓣是鼻整形术中一种有用且可重复的技术，效果持久。使用相邻软骨为矫正和支撑初次及修复性鼻整形术中的鼻小柱下外侧提供了局部的活组织来源。
