Durham, N.C. From the Interdisciplinary Craniofacial Imaging Laboratory; the Department of Surgery, Division of Plastic Surgery; the Department of Radiology; and the Department of Biomedical Engineering, Duke University; and CARE Plastic Surgery, P.A.
Plast Reconstr Surg. 2009 Dec;124(6):2107-2117. doi: 10.1097/PRS.0b013e3181bf7e3a.
The physiologic effects of specific rhinoplasty maneuvers are incompletely understood, largely because of a limited ability to objectively examine such interventions. The purpose of this study was to develop and validate a cadaveric model for rhinoplasty testing.
Ten cadaver heads were methodically prepared to simulate ventilatory conditions. Airway dimensions were measured with three-dimensional computed tomography and acoustic rhinometry. Airflow, pressure, and resistance were measured under conditions of both inhalation and exhalation. Resistance was determined using active anterior rhinomanometry and a continuously variable pressure gradient. Anatomic and physiologic properties were first compared against normative data. Measurements were then taken after application of an adhesive external midvault dilator (BreatheRight; GlaxoSmithKline).
The average minimal cross-sectional areas by acoustic rhinometry and by computed tomography were 0.87 cm2 and 0.84 cm2 per nostril, respectively (n = 20). The average distance from the nostril to the internal nasal valve was 1.7 cm by acoustic rhinometry and 1.5 cm by computed tomography, consistent with published in vivo normative data at the internal nasal valve. The average resistance with simulated exhalation closely approximated known normative values. With the application of the adhesive nasal dilator, the average area (acoustic rhinometry) increased by 50 percent at the internal nasal valve. During inhalation, the resistance decreased by 21 percent following application of the adhesive dilator.
The model provides an accurate representation of nasal anatomy and physiology suitable for objective analysis of rhinoplasty maneuvers. The objective modalities used herein may be applied to rhinoplasty study using this model with accuracy and reproducibility. The external dilator increased area at the internal valve (minimal cross-sectional area) and decreased resistance.
特定鼻整形术操作的生理效应尚未完全了解，主要是因为客观检查这些干预措施的能力有限。本研究的目的是开发和验证一种用于鼻整形术测试的尸体模型。
将十个尸体头颅进行了系统的准备，以模拟通气条件。气道尺寸使用三维计算机断层扫描和声学鼻测量法进行测量。在吸气和呼气两种情况下测量气流、压力和阻力。使用主动前鼻测压法和连续可变压力梯度来确定阻力。首先将解剖和生理特性与参考值进行比较。然后，在应用外部中隔扩张器（BreatheRight；葛兰素史克）后进行测量。
声学鼻测量法和计算机断层扫描的最小横截面积平均值分别为每侧鼻孔 0.87cm2 和 0.84cm2（n=20）。声学鼻测量法测量的鼻孔到鼻内阀的平均距离为 1.7cm，计算机断层扫描为 1.5cm，与鼻内阀的已知体内参考值一致。模拟呼气的平均阻力非常接近已知的参考值。应用粘性鼻扩张器后，鼻内阀的平均面积（声学鼻测量法）增加了 50%。在吸气时，应用粘性扩张器后阻力降低了 21%。
该模型提供了适合客观分析鼻整形术操作的准确鼻解剖和生理学表现。本文中使用的客观方式可用于该模型的鼻整形术研究，具有准确性和可重复性。外部扩张器增加了内阀（最小横截面积）的面积并降低了阻力。
