Bitik Ozan, Uzun Hakan, Kamburoğlu Haldun Onuralp, Dadaci Mehmet
Department of Plastic Surgery, Hacettepe University Faculty of Medicine, Sihhiye, Cankaya, 06100, Ankara, Turkey,
Aesthetic Plast Surg. 2014 Apr;38(2):309-15. doi: 10.1007/s00266-014-0307-5. Epub 2014 Mar 27.
Anterior septal height is an important determinant of nasal tip projection. Accordingly, the anterior septal extension technique has proven itself to be a powerful tool for achieving long-lasting nasal tip projection in rhinoplasty. However, anterior septal extension does not protect against postoperative loss of nasal tip rotation unless an additional suspension strategy is used. A tip-suspending transfixion suture is the authors' strategy for supporting nasal tip rotation whenever an anterior septal extension technique is performed.
Of 156 rhinoplasties performed by the authors between 2010 and 2012, a cohort of 22 droopy-tip rhinoplasties was extracted in which the described technique was used. The patients in this cohort were included in a retrospective nasal tip projection and rotation analysis. The nasolabial angle (NLA) and Goode ratio measurements were compared between preoperative, 3-week postoperative, and 1-year postoperative profile-view photographs.
The NLA and the Goode ratio measurements were significantly higher in the 3-week postoperative group than in the preoperative group, indicating an effective gain in both tip projection and rotation. The NLA and the Goode ratio measurements did not differ statistically between the postoperative 3-week and postoperative 1-year groups, indicating long-term maintenance of nasal tip position.
A tip-suspending transfixion suture is an easy method for securing nasal tip rotation when used in conjunction with an anterior septal extension.
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鼻中隔前部高度是鼻尖突出度的重要决定因素。因此，鼻中隔前部延伸技术已被证明是在鼻整形术中实现持久鼻尖突出度的有力工具。然而，除非采用额外的悬吊策略，鼻中隔前部延伸并不能防止术后鼻尖旋转度丧失。当采用鼻中隔前部延伸技术时，作者采用一种悬吊式贯穿缝合术来支持鼻尖旋转。
在作者于2010年至2012年期间进行的156例鼻整形术中，提取出一组22例使用上述技术的鼻尖下垂鼻整形术病例。该队列中的患者纳入一项回顾性鼻尖突出度和旋转度分析。比较术前、术后3周和术后1年侧面观照片的鼻唇角（NLA）和古德比率测量值。
术后3周组的NLA和古德比率测量值显著高于术前组，表明鼻尖突出度和旋转度均有效增加。术后3周组和术后1年组之间的NLA和古德比率测量值在统计学上无差异，表明鼻尖位置长期维持。
悬吊式贯穿缝合术与鼻中隔前部延伸联合使用时，是一种确保鼻尖旋转的简便方法。
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