Newport Beach, Calif.
Plast Reconstr Surg. 2009 Nov;124(5):1640-1648. doi: 10.1097/PRS.0b013e3181babcd1.
There have been relatively few articles in the English language on secondary Middle Eastern rhinoplasty. This article analyzes the cause and treatment of secondary Middle Eastern rhinoplasty.
A prospective study of 40 consecutive female secondary Middle Eastern rhinoplasty patients was completed.
The majority of secondary rhinoplasty patients were older than 25 years. Half of the patients had undergone a single prior rhinoplasty and the other half had undergone multiple operations, ranging in number from two to five. A wide variety of surgical techniques was necessary because of the broad range of presenting deformities, patients' requests, and the author's preferred procedures.
The principal reasons for secondary rhinoplasty in Middle Eastern patients were a failure to correct the original deformity and the presence of visible surgical stigmata. The persistent complaints were a poorly defined tip and a long, droopy nose. Surprisingly, most secondary rhinoplasty patients had thin skin (55 percent), which necessitated fascia or dermis grafts to conceal surgical stigmata. At the time of secondary surgery, there was an absence of structure in these noses as evidenced by the prior 0 percent insertion of spreader grafts and the 10 percent use of columellar struts in prior open cases. Also, there was little evidence of other structural grafts, including alar rim, alar battens, or lateral crural strut grafts. Insertion of structural support appears essential to control primary deformities and to repair secondary deformities.
英文文献中关于中东人鼻修复术的报道较少。本文分析了中东人鼻修复术的原因和治疗方法。
对 40 例连续的中东女性鼻修复术患者进行了前瞻性研究。
大多数鼻修复术患者年龄大于 25 岁。一半的患者接受过一次鼻整形术，另一半患者接受过多次手术，数量从两次到五次不等。由于存在广泛的畸形、患者的要求和作者首选的手术方式，需要采用各种不同的手术技术。
中东患者鼻修复术的主要原因是未能纠正原始畸形和存在明显的手术痕迹。持续存在的抱怨是鼻尖定义不明确和鼻子长而下垂。令人惊讶的是，大多数鼻修复术患者的皮肤较薄（55%），需要筋膜或真皮移植物来掩盖手术痕迹。在二次手术时，这些鼻子缺乏结构，表现在先前的鼻中隔移植物插入率为 0%，在前开病例中使用鼻中隔支撑物的比例为 10%。此外，很少有其他结构移植物的证据，包括鼻翼缘、鼻翼板或外侧穹隆支柱移植物。插入结构支撑物对于控制原发性畸形和修复继发性畸形似乎是必要的。
