Sepehr Ali, Alexander Ashlin J, Chauhan Nitin, Chan Harley, Adamson Peter A
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto General Hospital, Toronto, ON M5G 2N2, Canada.
Arch Facial Plast Surg. 2010 Nov-Dec;12(6):379-84. doi: 10.1001/archfacial.2010.87.
To apply a mathematical model to determine the relative effectiveness of various tip-plasty maneuvers while the lateral crura are in cephalic position compared with orthotopic position.
A Matlab (MathWorks, Natick, Massachusetts) computer program, called the Tip-Plasty Simulator, was developed to model the medial and lateral crura of the tripod concept in order to estimate the change in projection, rotation, and nasal length yielded by changes in crural length. The following rhinoplasty techniques were modeled in the software program: columellar strut graft/tongue-in-groove, lateral crural steal, lateral crural overlay, medial/intermediate crural overlay, hinge release with alar strut graft, and lateral crural repositioning.
Using the Tip-Plasty Simulator, the directionality of the change in projection, rotation, and nasal length produced by the various tip-plasty maneuvers, as shown by our mathematical model, is largely the same as that expected and observed clinically. Notably, cephalically positioned lateral crura affected the results of the rhinoplasty maneuvers studied.
By demonstrating a difference in the magnitude of change resulting from various rhinoplasty maneuvers, the results of this study enhance the ability of the rhinoplasty surgeon to predict the effects of various tip-plasty maneuvers, given the variable range in alar cartilage orientation that he or she is likely to encounter.
应用数学模型确定在外侧脚处于头侧位时与原位相比各种鼻尖整形手术操作的相对有效性。
开发了一个名为鼻尖整形模拟器的Matlab（MathWorks，马萨诸塞州纳蒂克）计算机程序，以模拟三脚架概念中的内侧和外侧脚，从而估计脚长度变化所产生的投影、旋转和鼻长度的变化。在该软件程序中对以下鼻整形技术进行了建模：鼻中隔支柱移植/榫槽法、外侧脚窃取、外侧脚覆盖、内侧/中间脚覆盖、带鼻翼支柱移植的铰链释放以及外侧脚重新定位。
使用鼻尖整形模拟器，我们的数学模型显示，各种鼻尖整形手术操作所产生的投影、旋转和鼻长度变化的方向性在很大程度上与临床预期和观察结果一致。值得注意的是，头侧位的外侧脚影响了所研究的鼻整形手术操作的结果。
通过展示各种鼻整形手术操作所导致的变化程度差异，本研究结果提高了鼻整形外科医生预测各种鼻尖整形手术操作效果的能力，因为他或她可能会遇到鼻翼软骨方向的可变范围。
