Lohuis Peter J F M, Faraj-Hakim Sara, Knobbe Arno, Duivesteijn Wouter, Bran Gregor M
Department of Otolaryngology/Head and Neck Surgery, Center for Facial Plastic and Reconstructive Surgery, Diakonessen Hospital Zeist, Zeist, the Netherlands.
Arch Facial Plast Surg. 2012 Sep-Oct;14(5):346-53. doi: 10.1001/archfacial.2012.606.
To describe the split hump technique (SHT) and to examine its effectiveness for correction of an overprojected nasal dorsum in patients undergoing aesthetic rhinoplasty.
This prospective study included 97 patients. Objective assessment was performed using a short, practical questionnaire. Investigation focused on nasal patency and the patient perception of body image in relation to nasal appearance using 5-point Likert scale questions and visual analog scales.
Use of the SHT resulted in a significant improvement in nasal patency and aesthetic nasal perception. Sum functional question scores decreased from 9.154 to 6.351 and aesthetic question scores from 13.897 to 6.825 (P < .001 for both). Mean aesthetic visual analog scale scores improved in all patients, from 3.346 to 7.782 (P < .001). Graphic illustration of this improvement revealed a gaussian curve of normal distribution around a mean (SD) improvement of 4.48 (1.93).
Traditional en bloc humpectomy maneuvers are frequently combined with spreader graft use to avoid postoperative inferomedial repositioning of the upper lateral cartilages and inverted-V deformity. The SHT for correction of the overprojected dorsum creates a paradigm change in this patient group. The transverse segments of the upper lateral cartilages are saved and repositioned instead of being resected as a part of an en bloc osseocartilaginous composite hump resection in a transverse plane. Several modifications of the SHT enable the surgeon to deproject the nose while keeping sufficient strength in the keystone area and augmenting dorsal width. Using statistical analysis of subjective patient data, we could prove a broad acceptance and appreciation for the SHT.
描述驼峰劈开技术（SHT），并探讨其在美容鼻整形术中矫正鼻背过度突出的有效性。
这项前瞻性研究纳入了97例患者。使用简短实用的问卷进行客观评估。调查重点是鼻通气情况以及患者对与鼻外观相关的身体形象的感知，采用5分制李克特量表问题和视觉模拟量表。
使用SHT后，鼻通气和鼻美学感知有显著改善。功能问题总分从9.154降至6.351，美学问题总分从13.897降至6.825（两者P <.001）。所有患者的美学视觉模拟量表平均得分均有改善，从3.346提高到7.782（P <.001）。这种改善的图形显示为围绕平均（标准差）改善值4.48（1.93）的正态分布高斯曲线。
传统的整块驼峰切除术常与使用撑开移植物相结合，以避免术后上外侧软骨向内下移位和倒V形畸形。用于矫正过度突出鼻背的SHT在该患者群体中带来了范式转变。上外侧软骨的横段得以保留并重新定位，而不是作为整块骨软骨复合驼峰切除术的一部分在横断面上切除。SHT的几种改良方法使外科医生能够降低鼻背高度，同时在关键区域保持足够的强度并增加鼻背宽度。通过对患者主观数据的统计分析，我们可以证明SHT得到了广泛的接受和认可。
