Aydogan Filiz, Tastan Eren, Aydin Emine, Emir Hatice Karadas, Tuzuner Arzu, Demirci Sule, Samim Erdal
Ministry of Health, Department of Otorhinolaryngology, Ankara Training and Research Hospital, Ulucanlar, Ankara, Turkey,
Aesthetic Plast Surg. 2014 Apr;38(2):288-94. doi: 10.1007/s00266-014-0295-5. Epub 2014 Mar 12.
The aim of this study was to compare the degree of nasal tip rigidity from different techniques for increasing nasal tip projection.
Retrospective records of patients who had undergone rhinoplasty were reviewed at the tertiary referral center. 81 patients who had undergone suturing of the medial crura to the extension graft or to the long septum were selected. In group A, fixation was performed at the same level compared to before surgery. In group B, tip grafting was performed to gain 3 mm or more in projection after fixation as done in group A. In group C, the same tip projection was provided by advancing the medial crura on the caudal septum or extension graft. Patients were evaluated with a visual analog scale, based on the rigidity of the nasal tip (0=very flexible, 10=very rigid).
When the preoperative and postoperative VAS scores of all groups were compared, postoperative scores were significantly higher than the preoperative scores (p<0.001). The postoperative scores of group C were higher than those of the other groups. These differences were statistically significant (p<0.001). There was no statistically significant difference between groups A and B with regard to the postoperative scores (p=0.389). However, in group C, the increase between preoperative and postoperative scores was significantly higher than in the other groups (p<0.001).
Advancing the medial crura on the caudal septum and suturing to gain 3 mm or more of tip projection may result in a more rigid nasal tip. Patients should be informed preoperatively of this potential result.
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本研究的目的是比较不同增加鼻尖突出度技术的鼻尖硬度。
在三级转诊中心回顾接受过隆鼻手术患者的回顾性记录。选择81例接受内侧脚缝合至延伸移植物或长鼻中隔的患者。A组，固定在与手术前相同的水平。B组，如A组一样固定后进行鼻尖移植以增加3毫米或更多的突出度。C组，通过将内侧脚向尾侧鼻中隔或延伸移植物推进来提供相同的鼻尖突出度。根据鼻尖硬度，使用视觉模拟量表对患者进行评估（0 =非常灵活，10 =非常僵硬）。
比较所有组的术前和术后VAS评分时，术后评分显著高于术前评分（p < 0.001）。C组的术后评分高于其他组。这些差异具有统计学意义（p < 0.001）。A组和B组的术后评分之间无统计学显著差异（p = 0.389）。然而，C组术前和术后评分的增加显著高于其他组（p < 0.001）。
将内侧脚向尾侧鼻中隔推进并缝合以增加3毫米或更多的鼻尖突出度可能会导致鼻尖更硬。应在术前告知患者这一潜在结果。
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