Patrocínio Lucas G, Patrocínio Tomas G, Maniglia Jose V, Patrocínio Jose A
Division of Facial Plastic Surgery, Medical School, Federal University of Uberlandia, Minas Gerais, Brazil.
Arch Facial Plast Surg. 2009 Jul-Aug;11(4):221-9. doi: 10.1001/archfacial.2009.37.
To present a graduated approach to refining the nasal lobule (a frequent complaint during consultations for rhinoplasty) based on anatomic features and to discuss the casuistics of this procedure since we began performing it.
A retrospective evaluation of the medical charts of 1152 patients who underwent rhinoplasty from 2003 to 2006; 641 patients fulfilled the criteria for our study (55.6%). Outcomes were assessed by comparing preoperative and last follow-up photographs and considering the width, symmetry, and contour of the nasal lobule. Cases were allocated into 7 groups: (1) no surgery on nasal tip; (2) interdomal breakup; (3) cephalic trim; (4) domal suture; (5) shield-shaped graft; (6) vertical dome division; and (7) replacement of lower lateral cartilages.
Of the 641 patients enrolled in the study, 435 were women and 206 were men. Mean follow-up period was 1.5 years. An asymmetric tip was present in 28 patients (4.4%), and a persistent width of interdomal space in 34 (5.3%). None presented overnarrowing of interdomal space. Surgical revision rate to enhance refinement of the lobule was 5.6%.
Our graduated approach has shown excellent outcomes, a high rate of patient satisfaction, and a low rate of revision.
基于解剖学特征，提出一种逐步改进鼻小叶（隆鼻手术咨询中常见的问题）的方法，并讨论自我们开展该手术以来的病例情况。
对2003年至2006年接受隆鼻手术的1152例患者的病历进行回顾性评估；641例患者符合我们的研究标准（55.6%）。通过比较术前和最后随访照片，并考虑鼻小叶的宽度、对称性和轮廓来评估结果。病例分为7组：（1）鼻尖未手术；（2）鼻间分离；（3）软骨头部修剪；（4）鼻翼缝合；（5）盾牌状移植；（6）垂直鼻翼分隔；（7）下外侧软骨置换。
在纳入研究的641例患者中，女性435例，男性206例。平均随访期为1.5年。28例患者（4.4%）存在鼻尖不对称，34例患者（5.3%）鼻间间隙持续增宽。无一例出现鼻间间隙过窄。为提高鼻小叶精细度而进行手术修复的比例为5.6%。
我们的逐步方法显示出了优异的效果、较高的患者满意度和较低的修复率。
