Heppt W, Hildenbrand T
Hals-, Nasen-, Ohrenklinik, Kopf-, Hals-, Plastische Gesichtschirurgie, Städtisches Klinikum Karlsruhe, Lehrkrankenhaus der Albert-Ludwigs-Universität Freiburg i. Br., Moltkestr. 90, 76133 Karlsruhe, Deutschland.
HNO. 2011 Aug;59(8):831-43; quiz 844-5. doi: 10.1007/s00106-011-2324-x.
In general septoplasty precedes all other procedures in rhinoplasty as a straight, stable septum dictates the aesthetic and functional outcome. The patient's history and expectations, correct preoperative analysis and the surgeon's skills determine the approach in septum correction. As a rule of thumb, slight deviations, e.g. single vomer spurs, maxillary crests, the septal tilt and simple C and S-shaped deformities can be managed endonasally using a hemitransfixion incision and procedures such as the swinging door technique, scoring, batten grafts or caudal septal replacement grafts. In contrast, for severe S-shaped and wave-like deviations, cleft nose deformities, the multiple fractured septum as well as for most revision cases, the open approach with complete septal reconstruction has been found to be the method of choice. After initial general remarks on the basic procedures, the present article focuses on current concepts of septum correction which have to be adapted to the individual pathology.
一般来说，鼻中隔成形术在鼻整形术中先于所有其他手术，因为笔直、稳定的鼻中隔决定了美学和功能效果。患者的病史和期望、正确的术前分析以及外科医生的技能决定了鼻中隔矫正的方法。一般来说，轻微的鼻中隔偏曲，如单个犁骨棘、上颌嵴、鼻中隔倾斜以及简单的C形和S形畸形，可以通过半鼻中隔切开术切口并采用诸如摇门技术、划痕、支撑移植物或鼻中隔尾端替代移植物等方法经鼻内处理。相比之下，对于严重的S形和波浪状偏曲、腭裂鼻畸形、多处骨折的鼻中隔以及大多数修复病例，已发现采用完全鼻中隔重建的开放式手术方法是首选。在对基本手术进行初步概述之后，本文重点关注鼻中隔矫正的当前概念，这些概念必须根据个体病理情况进行调整。
