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鼻尖精细化的渐进式方法：手术结果

Gradual approach to refinement of the nasal tip: surgical results.

作者信息

Carvalho Thiago Bittencourt Ottoni de, Thomazi Emerson, Leutz Rafael Panizza, Souza Rafael P S F, Molina Fernando Drimel, Piatto Vânia Belintani, Maniglia José Victor

机构信息

Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço do Hospital de Base de São José do Rio Preto - Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, SP, Brazil.

Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço do Hospital de Base de São José do Rio Preto - Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, SP, Brazil.

出版信息

Braz J Otorhinolaryngol. 2015 Jan-Feb;81(1):31-6. doi: 10.1016/j.bjorl.2014.04.003. Epub 2014 Oct 18.

DOI:10.1016/j.bjorl.2014.04.003
PMID:25458261
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9452191/
Abstract

INTRODUCTION

The complexity of the nasal tip structures and the impact of surgical maneuvers make the prediction of the final outcome very difficult. Therefore, no single technique is enough to correct the several anatomical presentations, and adequate preoperative planning represents the basis of rhinoplasty.

OBJECTIVE

To present results of rhinoplasty, through the gradual surgical approach to nasal tip definition based on anatomical features, and to evaluate the degree of patient satisfaction after the surgical procedure.

METHODS

Longitudinal retrospective cohort study of the medical charts of 533 patients of both genders who underwent rhinoplasty from January of 2005 to January of 2012 was performed. Cases were allocated into seven groups: (1) no surgery on nasal tip; (2) interdomal breakup; (3) cephalic trim; (4) domal suture; (5) shield-shaped graft; (6) vertical dome division; (7) replacement of lower lateral cartilages.

RESULTS

Group 4 was the most prevalent. The satisfaction rate was 96% and revision surgery occurred in 4% of cases.

CONCLUSION

The protocol used allowed the implementation of a gradual surgical approach to nasal tip definition with the nasal anatomical characteristics, high rate of patient satisfaction with the surgical outcome, and low rate of revision.

摘要

引言

鼻尖结构的复杂性以及手术操作的影响使得预测最终结果非常困难。因此，没有一种单一技术足以纠正多种解剖学表现，充分的术前规划是鼻整形术的基础。

目的

通过基于解剖特征的逐步手术方法来确定鼻尖，呈现鼻整形术的结果，并评估手术后患者的满意度。

方法

对2005年1月至2012年1月期间接受鼻整形术的533例男女患者的病历进行纵向回顾性队列研究。病例分为七组：（1）鼻尖未手术；（2）鼻间分离；（3）切除鼻翼软骨头部；（4）鼻翼软骨缝合；（5）盾牌状移植；（6）垂直鼻翼软骨分离；（7）更换下外侧软骨。

结果

第4组最为常见。满意率为96%，4%的病例进行了修复手术。

结论

所采用的方案允许根据鼻部解剖特征逐步采用手术方法来确定鼻尖，患者对手术结果的满意率高，修复率低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f110/9452191/3506fee11dd4/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f110/9452191/d32b153c6b9b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f110/9452191/2e8beeb1a159/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f110/9452191/ac39b82522c5/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f110/9452191/6c944b021cae/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f110/9452191/7ca0d1eace18/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f110/9452191/3506fee11dd4/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f110/9452191/d32b153c6b9b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f110/9452191/2e8beeb1a159/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f110/9452191/ac39b82522c5/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f110/9452191/6c944b021cae/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f110/9452191/7ca0d1eace18/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f110/9452191/3506fee11dd4/gr6.jpg

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本文引用的文献

1
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Arch Facial Plast Surg. 2009 Jul-Aug;11(4):221-9. doi: 10.1001/archfacial.2009.37.
2
Tip shaping in primary rhinoplasty: an algorithmic approach.原发性鼻整形术中的鼻尖塑形：一种算法方法。
Plast Reconstr Surg. 2008 Oct;122(4):1229-1241. doi: 10.1097/PRS.0b013e31817d5f7d.
3
A systematic approach for preoperative rhinoplasty planning.一种用于鼻整形术前规划的系统方法。
Am J Otolaryngol. 2008 Jul-Aug;29(4):265-9. doi: 10.1016/j.amjoto.2007.06.001. Epub 2008 Mar 20.
4
Reconstructive rhinoplasty: the 3-dimensional nasal tip.鼻整形修复术：三维鼻尖
Arch Facial Plast Surg. 2006 May-Jun;8(3):195-201. doi: 10.1001/archfaci.8.3.195.
5
Skin and subcutaneous tissue in rhinoplasty.鼻整形术中的皮肤和皮下组织。
Aesthetic Plast Surg. 2002 Nov;26 Suppl 1:S19. doi: 10.1007/s00266-002-4323-5.
6
Suture algorithm for the broad or bulbous nasal tip.
Plast Reconstr Surg. 2002 Dec;110(7):1752-64; discussion 1765-8. doi: 10.1097/01.PRS.0000033873.20163.61.
7
The boxy nasal tip: classification and management based on alar cartilage suturing techniques.方形鼻尖：基于鼻翼软骨缝合技术的分类与处理
Plast Reconstr Surg. 2001 Jun;107(7):1849-63; discussion 1864-8.
8
Rhinoplasty: a practical guide for surgical planning.隆鼻术：手术规划实用指南。
Plast Reconstr Surg. 1993 Apr;91(4):642-54; discussion 655-6.