Zhou Jia, Huang Xiaolu, Zheng Danning, Li Haizhou, Herrler Tanja, Li Qingfeng
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
Aesthetic Plast Surg. 2014 Apr;38(2):295-302. doi: 10.1007/s00266-014-0299-1. Epub 2014 Mar 14.
The currently recommended strategies for short nose elongation were designed primarily for the Caucasian nasal framework. For Oriental patients, more elongation often is required because a hypoplastic septal cartilage requires more elongation, resulting in a higher risk of complications. This report proposes a modified technique for Oriental nose elongation, which adjusts the pressure points after nasal elongation using an L-shaped implant.
Between January 2007 and December 2009, 58 patients underwent Oriental nose elongation using an L-shaped, porous, high-density polyethylene sheet implant. Augmentation rhinoplasty and conchal cartilage shield grafts were performed depending on the nasal shape. Pre- and postoperative nasal length, height, and projection as well as columella-labial angle, columella-lobular angle, and nasal tip angle were measured and compared. A patient satisfaction survey was performed postoperatively. All occurring complications were recorded.
The postoperative nasal length was significantly elongated from 47.0±10.4 mm to 49.3±10.1 mm (p=0.003), and the nasal height increased significantly from 48.5±9.1 mm to 50.4±8.5 mm (p=0.011). The initially obtuse columella-labial angle improved significantly from 100.8°±12.1° to 92.5°±15.5° (p=0.014). No significant changes were found regarding nasal projection, nasal tip angle, or columella-lobular angle. The majority of the patients (91.3%) were highly satisfied or satisfied with the aesthetic results. A major complication in terms of implant exposure was observed in one case. The minor complications included stiffness of the nasal tip (3 patients) and tip redness (1 patient).
In Oriental nose elongation, the use of an L-shaped graft is a feasible and safe treatment option that allows for an excellent aesthetic outcome and reduces the incidence of complications.
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目前推荐的短鼻延长策略主要是针对高加索人的鼻框架设计的。对于东方患者，由于鼻中隔软骨发育不全需要更多的延长，因此通常需要更大程度的延长，这导致并发症风险更高。本报告提出了一种针对东方人鼻延长的改良技术，该技术使用L形植入物在鼻延长后调整压力点。
2007年1月至2009年12月期间，58例患者使用L形多孔高密度聚乙烯片植入物进行东方人鼻延长术。根据鼻形进行隆鼻术和耳甲软骨盾牌移植。测量并比较术前和术后的鼻长度、高度、突出度以及鼻小柱-唇角、鼻小柱-小叶角和鼻尖角。术后进行患者满意度调查。记录所有发生的并发症。
术后鼻长度从47.0±10.4mm显著延长至49.3±10.1mm（p = 0.003），鼻高度从48.5±9.1mm显著增加至50.4±8.5mm（p = 0.011）。最初钝圆的鼻小柱-唇角从100.8°±12.1°显著改善至92.5°±15.5°（p = 0.014）。鼻突出度、鼻尖角或鼻小柱-小叶角未见显著变化。大多数患者（91.3%）对美学效果高度满意或满意。1例出现植入物外露的主要并发症。次要并发症包括鼻尖僵硬（3例患者）和鼻尖发红（1例患者）。
在东方人鼻延长术中，使用L形移植物是一种可行且安全的治疗选择，可实现出色的美学效果并降低并发症发生率。
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