Sinno Sammy, Chang Jessica B, Saadeh Pierre B, Lee Michael R
New York, N.Y.; and Shreveport, La. From the Department of Plastic Surgery, New York University; and The Wall Center for Plastic Surgery.
Plast Reconstr Surg. 2015 May;135(5):838e-848e. doi: 10.1097/PRS.0000000000001169.
Although the majority of nasal alterations in rhinoplasty result from either augmentation or reduction of bone and cartilaginous substructure, modifications of influential soft-tissue provide significant contribution to the final result. The depressor septi nasi muscle is a soft-tissue structure well known to influence the final result in rhinoplasty. The objective of this study was to perform a standardized, comprehensive review of relevant data published with regard to the depressor septi nasi muscle.
A comprehensive search of the terms "depressor septi muscle" and "depressor septi nasi muscle" was performed using the PubMed, MEDLINE, and Cochrane databases. Articles were reviewed for relevancy and included if criteria were met. A secondary review was performed of all articles cited, to maximize diligence.
Forty-three articles were identified in the initial search. Thirteen of the 43 were found to meet inclusion criteria. Secondary search revealed additional studies meeting inclusion criteria. Altogether, there were 175 cadaver specimens and 821 surgically treated patients for which data were available. Anatomical reports and nomenclature were found to vary. Surgical approach and muscle treatment diverged, with objective data showing no superior method.
Although variation exists in anatomical reports regarding the depressor septi nasi muscle, the prevailing thought is that it originates from the maxilla and/or orbicularis oris muscle. More importantly, the muscle inserts on the medial crura and adjacent soft tissue. Disruption of this relationship provides the basis for surgical treatment of tip descent on animation.
尽管隆鼻术中大多数鼻腔改变是由于鼻骨和软骨亚结构的增大或缩小，但有影响力的软组织的改变对最终效果也有重要贡献。降鼻中隔肌是一种软组织结构，在隆鼻术中对最终效果的影响众所周知。本研究的目的是对已发表的有关降鼻中隔肌的相关数据进行标准化的综合回顾。
使用PubMed、MEDLINE和Cochrane数据库对“降鼻中隔肌”和“降鼻中隔肌”进行全面检索。对文章进行相关性审查，符合标准的文章予以纳入。对所有引用的文章进行二次审查，以最大限度地提高严谨性。
在初步检索中识别出43篇文章。43篇中有13篇符合纳入标准。二次检索发现了其他符合纳入标准的研究。总共获得了175个尸体标本和821例接受手术治疗患者的数据。发现解剖学报告和命名存在差异。手术方法和肌肉处理各不相同，客观数据显示没有 superior 方法。
尽管关于降鼻中隔肌的解剖学报告存在差异，但普遍认为它起源于上颌骨和/或口轮匝肌。更重要的是，该肌肉附着于内侧脚和相邻的软组织。这种关系的破坏为动态鼻尖下垂的手术治疗提供了基础。
