Kim Jae Hoon, Song Jin Woo, Park Sung Wan, Oh Won Suk, Lee Joo Heon
April 31 Plastic Surgery Clinic, Seoul, Korea.
Arch Plast Surg. 2014 Jan;41(1):3-11. doi: 10.5999/aps.2014.41.1.3. Epub 2014 Jan 13.
This study aimed at overcoming the disadvantages of septal extension grafts and keeping the nasal tip as natural as possible by using different forms of the graft and additional supporting methods depending on the case.
Among 458 patients who received a septal extension graft from March 2008 to September 2011, 107 patients were selected who underwent at least a 6-month follow-up. Patients were categorized according to the primary objective of the operation; an upturned tip correction or tip lengthening, tip lengthening with tip projection, or retracted columella correction. Each group of patients received a different type of septal extension graft out of 3 different types of grafts based on the purpose of the operation. The evaluation of the results was made from by comparing preoperative and postoperative photographs of the tip angle, projection, and nasolabial angle.
The average tip angle for the patients in the upturned tip correction group was reduced to 98.3 from 124.9 degrees. For the patients in the tip lengthening with tip projection group, the average tip angle was reduced to 96.8 from 122.4 degrees and the average tip projection was increased to 27.5 from 23.2 mm. The average nasolabial angle for the patients in the retracted columella correction group was increased to 94.6 from 74.8 degrees.
Sufficient nasal tip lengthening and projection could be achieved by applying a septal extension graft using the graft best suited for the group of patients categorized by surgical objective.
本研究旨在克服鼻中隔延长移植物的缺点,并根据具体情况采用不同形式的移植物和额外的支撑方法,尽可能使鼻尖保持自然状态。
在2008年3月至2011年9月接受鼻中隔延长移植物的458例患者中,选择107例至少随访6个月的患者。根据手术的主要目的对患者进行分类;鼻尖上翘矫正或鼻尖延长、鼻尖延长伴鼻尖突出或鼻中隔退缩矫正。根据手术目的,每组患者接受3种不同类型移植物中的一种不同类型的鼻中隔延长移植物。通过比较术前和术后鼻尖角度、突出度和鼻唇角的照片来评估结果。
鼻尖上翘矫正组患者的平均鼻尖角度从124.9度降至98.3度。对于鼻尖延长伴鼻尖突出组的患者,平均鼻尖角度从122.4度降至96.8度,平均鼻尖突出度从23.2毫米增加到27.5毫米。鼻中隔退缩矫正组患者的平均鼻唇角从74.8度增加到94.6度。
通过使用最适合按手术目的分类的患者组的移植物进行鼻中隔延长移植物植入,可以实现足够的鼻尖延长和突出。