Thomassin J-M, Radulesco T, Bardot J
Service d'ORL et chirurgie cervico-faciale, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France.
Service d'ORL et chirurgie cervico-faciale, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France.
Ann Chir Plast Esthet. 2014 Dec;59(6):498-507. doi: 10.1016/j.anplas.2014.07.022. Epub 2014 Aug 28.
Correction of a twisted or crooked nose can be very complex and require the use of a broad range of surgical techniques. Patient needs are often mixed--aesthetic and functional--particularly in post-trauma cases. The quality of postoperative breathing is therefore as important as correction of the nasal deviation. Extracorporeal septoplasty or spreader grafts are very effective not only in correction of the nasal pyramid deformation, but also in resolution of functional respiratory issues. Reconstruction and proper support of the septum are necessary components for a straight nose. Aesthetic deformation can be difficult to correct owing to the memory of the bone and cartilage. Although minor deformations can be corrected with simple techniques, a more aggressive procedure is often necessary in the most complex cases. Despite attempts to correct deformation thanks to the various techniques described here, a postoperative deviation can persist. Preoperative discussion is very important and enables the surgeon to explain to the patient that it is very difficult to obtain a perfectly straight nose.
矫正扭曲或歪斜的鼻子可能非常复杂，需要使用多种外科技术。患者的需求往往是综合的——美观和功能方面都有，尤其是在创伤后病例中。因此，术后呼吸质量与矫正鼻偏一样重要。体外鼻中隔成形术或撑开移植物不仅在矫正鼻锥体畸形方面非常有效，而且在解决功能性呼吸问题方面也很有效。鼻中隔的重建和适当支撑是鼻子变直的必要组成部分。由于骨骼和软骨的记忆，美学变形可能难以矫正。虽然轻微变形可以用简单技术矫正，但在最复杂的病例中通常需要更积极的手术。尽管尝试使用这里描述的各种技术来矫正变形，但术后偏差仍可能持续存在。术前讨论非常重要，能让外科医生向患者解释很难获得一个完美笔直的鼻子。
