Amali Amin, Sazgar Amir A, Jafari Mehrdad
Department of Otorhinolaryngology, Head and Neck Surgery at Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Otorhinolaryngology, Head and Neck Surgery at Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
Aesthet Surg J. 2014 Jul;34(5):687-95. doi: 10.1177/1090820X14529647. Epub 2014 Jul 1.
Postrhinoplasty nasal obstruction has been ascribed to either postreductive narrowing of the midvault or dynamic collapse resulting from lateral wall insufficiency. Recently, clinicians have reported on various surgical techniques that maximally preserve alar cartilage integrity, unlike the earlier popular methods of tip reduction surgery.
The authors compared the effects of 2 rhinoplasty techniques: a cephalic trim (CT) of the lateral crura (LC) and a horizontal resection with cephalic hinged flap (HRCH) of the LC of the lower lateral cartilage (LLC).
Fifty-two patients who presented with a bulbous nasal tip deformity were randomly assigned to 1 of 2 groups and underwent either CT of the LC or HRCH. Effects of the procedures were evaluated by both acoustic rhinometry (AR; first and second minimal cross-sectional areas [MCA1 and MCA2, respectively]) and by subjective scoring on a global nasal obstruction visual analog scale (VAS). Assessments were made before and after rhinoplasty.
MCA1 and MCA2 were increased after both CT and HRCH. This increase was significant on the right side for both CT (P < .001) and HRCH (P = .001), but the increase on the left side was significant only for HRCH.
The improvement noted in breathing quality by VAS and AR suggests that a hinged flap may be effective in reconstructing the internal nasal valve.
鼻整形术后鼻塞的原因被认为是鼻中段复位后变窄或侧壁功能不全导致的动态塌陷。最近，临床医生报道了各种能最大程度保留鼻翼软骨完整性的手术技术，这与早期流行的鼻尖缩小手术方法不同。
作者比较了两种鼻整形技术的效果：外侧脚（LC）的头侧修剪（CT）和下外侧软骨（LLC）的LC的带蒂头侧皮瓣水平切除术（HRCH）。
52例鼻尖圆钝畸形患者被随机分为两组，分别接受LC的CT或HRCH手术。通过鼻声反射（AR；分别为第一和第二最小横截面积[分别为MCA1和MCA2]）以及整体鼻塞视觉模拟量表（VAS）的主观评分来评估手术效果。在鼻整形术前和术后进行评估。
CT和HRCH术后MCA1和MCA2均增加。CT（P <.001）和HRCH（P =.001）右侧的增加均有统计学意义，但左侧仅HRCH的增加有统计学意义。
VAS和AR显示呼吸质量有所改善，这表明带蒂皮瓣可能对重建鼻内阀有效。
3级。
