Solomon Philip, Rival Richard, Mabini Aimee, Boyd Jennifer
Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario.
Can J Plast Surg. 2008 Winter;16(4):224-7. doi: 10.1177/229255030801600412.
The overprojected nasal tip presents a significant challenge to the surgeon performing rhinoplasty. Full transfixion incision as a means of dealing with this deformity has been studied only in combination with other surgical methods.
To determine whether transfixion incision alone would result in significant nasal tip deprojection, and if skin thickness had an effect on the extent of deprojection the procedure yielded.
Seventy-two consecutive patients with an aesthetic goal of nasal tip deprojection were enrolled. The sole surgical means of deprojection used was transfixion incision. Subjects were categorized as thin-, medium- or thick-skinned based on the surgeon's analysis. These groups were compared in terms of their postprocedural nasal tip deprojection.
Using transfixion incision as the sole means of correcting this deformity resulted in a mean nasal tip deprojection of 1.6 mm (ranging from 0 mm to 3 mm). Patients in the thin skin group had a mean deprojection of 2.12 mm. This was significantly greater than for both the medium- and thick-skinned groups. There was no significant difference between the medium- and thick-skinned groups.
Surgeons may use skin thickness when planning interventions for correcting nasal tip overprojection. When used alone, transfixion incision resulted in tip deprojection comparable with that achieved when combined with other methods, particularly for thin-skinned patients. Surgeons can thus use a graduated approach in which transfixion incision, the least destructive method, is used before proceeding with other interventions.
鼻尖过度突出给进行隆鼻手术的外科医生带来了重大挑战。全贯通切口作为处理这种畸形的一种方法，仅在与其他手术方法联合使用时得到研究。
确定单独的贯通切口是否会导致鼻尖显著下移，以及皮肤厚度是否会对该手术产生的下移程度有影响。
连续纳入72例以鼻尖下移为美学目标的患者。所用的唯一下移手术方法是贯通切口。根据外科医生的分析，将受试者分为薄皮、中皮或厚皮组。比较这些组术后鼻尖下移情况。
使用贯通切口作为纠正这种畸形的唯一方法，导致鼻尖平均下移1.6毫米（范围为0毫米至3毫米）。薄皮组患者的平均下移为2.12毫米。这显著大于中皮组和厚皮组。中皮组和厚皮组之间没有显著差异。
外科医生在计划纠正鼻尖过度突出的干预措施时可考虑皮肤厚度。单独使用时，贯通切口导致的鼻尖下移与与其他方法联合使用时相当，尤其是对于薄皮患者。因此，外科医生可以采用一种分级方法，在进行其他干预之前先使用破坏性最小的贯通切口。
