Department of Plastic and Reconstructive Surgery, Medical Faculty, Baskent University, Seyhan, Adana, Turkey.
Aesthetic Plast Surg. 2010 Oct;34(5):587-95. doi: 10.1007/s00266-010-9512-z. Epub 2010 Apr 10.
Nasomaxillary depression, which may be seen with major saddle nose deformities, especially as a sequel to childhood nasal trauma, generally is overlooked during management of the saddle nose. To handle both the saddle nose deformity and nasomaxillary depression, the authors used a one-stage intraoral and external open rhinoplasty approach for 12 patients. Lateral nasal osteotomies and correction of midface retrusion with crescent-shaped autogenous rib cartilage grafts were performed through two bilateral intraoral gingivobuccal incisions. The external open rhinoplasty approach was used for the correction of the saddle nose deformities. The mean follow-up period after the surgery was 2 years (range, 1-3.5 years). The correction of nasal tip depression resulting from midface retrusion was evaluated by lateral cephalometric radiographs. The mean movement of the nasal tip anteriorly in the sagittal plane 1 year after the operation was 5.5 mm (range, 4-7 mm). The functional and aesthetic results were satisfactory for all the patients. As the findings show, the intraoral part of the approach provides a route for the placement of cartilage grafts to correct the depressed nasal tip, augment the paranasal area, and provide support to the lateral alar bases and the controlled low-to-low lateral osteotomies. The external part of the approach provides correction of the saddle nose deformity.
鞍鼻畸形，尤其是儿童期鼻外伤后，可能会出现鼻根凹陷，在处理鞍鼻畸形时通常会忽略。为了处理鞍鼻畸形和鼻根凹陷，作者对 12 例患者采用了一期经口内外开放式鼻整形术。通过两个双侧口腔牙龈颊侧切口进行侧鼻切开术和新月形自体肋软骨移植矫正中面部后缩。经口外开放式鼻整形术用于矫正鞍鼻畸形。术后平均随访时间为 2 年（1-3.5 年）。通过侧位头颅侧位片评估中面部后缩导致的鼻尖凹陷矫正情况。术后 1 年，鼻尖在矢状面上向前移动的平均值为 5.5 毫米（范围 4-7 毫米）。所有患者的功能和美学效果均令人满意。研究结果表明，该入路的口内部分为放置软骨移植物提供了一种途径，可矫正凹陷的鼻尖、增加额旁区域，并为外侧鼻翼基底和控制低位低位侧骨切开术提供支撑。该入路的口外部分可矫正鞍鼻畸形。
