Bitik Ozan, Uzun Hakan, Kamburoğlu Haldun O, Çaliş Mert, Zins James E
Ankara, Turkey; and Cleveland, Ohio From the Department of Plastic Surgery, Hacettepe University Faculty of Medicine; and the Section of Cosmetic Surgery, Cleveland Clinic Foundation.
Plast Reconstr Surg. 2015 Apr;135(4):987-997. doi: 10.1097/PRS.0000000000001263.
The effect of a columellar strut graft on final nasal tip position has been a subject of ongoing debate. The purpose of this study was to retrospectively analyze a series of 100 consecutive primary rhinoplasty cases performed without the use of columellar strut grafts, with a specific focus directed toward comparing preoperative, morphed, and actual postoperative changes in nasal tip position.
Data were collected from patient charts and digital images of 100 consecutive primary open rhinoplasty patients. Preoperative, morphed, and actual postoperative digital images were quantitatively analyzed using image-processing software to compare various anatomical features, including nasal tip projection, nasolabial angle, and Goode ratio. Patient satisfaction regarding long-term postoperative results was also surveyed.
Primary rhinoplasty did not demonstrate a universal trend toward either an increase or a decrease in nasal tip projection. The planned changes in nasal tip projection, nasal tip rotation, and nasal profile proportions were obtained with statistically significant accuracy without the use of columellar strut grafts. The overall incidence of columellar contour irregularities was 3 percent.
In primary open approach rhinoplasty, if native anatomical support structures of the nasal tip are preserved or reconstructed, preoperative goals regarding nasal tip projection, nasal profile proportions, and columellar integrity can be consistently achieved without using columellar strut grafts.
鼻小柱支撑移植物对鼻尖最终位置的影响一直是一个持续争论的话题。本研究的目的是回顾性分析一系列连续100例未使用鼻小柱支撑移植物的初次鼻整形手术病例，特别关注比较术前、模拟和实际术后鼻尖位置的变化。
从100例连续初次开放式鼻整形手术患者的病历和数字图像中收集数据。使用图像处理软件对术前、模拟和实际术后数字图像进行定量分析，以比较各种解剖特征，包括鼻尖突出度、鼻唇角和古德比率。还对患者对术后长期效果的满意度进行了调查。
初次鼻整形手术在鼻尖突出度方面未表现出普遍的增加或减少趋势。在不使用鼻小柱支撑移植物的情况下，鼻尖突出度、鼻尖旋转和鼻外形比例的计划变化在统计学上具有显著的准确性。鼻小柱轮廓不规则的总体发生率为3%。
在初次开放式鼻整形手术中，如果保留或重建鼻尖的天然解剖支撑结构，则无需使用鼻小柱支撑移植物即可始终实现关于鼻尖突出度、鼻外形比例和鼻小柱完整性的术前目标。
