Lehrman Craig R, Lee Michael R, Ramanadham Smita, Rohrich Rod J
Dallas, Texas.
From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
Plast Reconstr Surg. 2016 Jun;137(6):950e-953e. doi: 10.1097/01.prs.0000481836.06127.d5.
Rhinoplasty remains one of the most commonly performed operations in plastic surgery. Little is known regarding the use of imaging in secondary rhinoplasty. Secondary rhinoplasty is a far more complex operation than primary rhinoplasty. The objective of this study was to assess the role of software imaging in patients undergoing secondary rhinoplasty.
A retrospective review was performed to identify patients undergoing secondary rhinoplasty performed by the senior author (R.J.R.) from January of 2000 to August of 2013. Forty consecutive patients met inclusion criteria. The degree of improvement was graded in comparison with both the preoperative photographs and software imaging using a graded scale.
A total of 40 patients met inclusion criteria. There were 35 women (87.5 percent) and five men (12.5 percent). The nasal dorsum was found to have an average rating of 2.36 between the two observers, the midvault had an average rating of 2.65, the nasal tip had an average rating of 2.27, the nasal alae had an average rating of 2.63, and the nasal base had an average score of 2.99 CONCLUSIONS:: Based on the results of this study, the authors have determined that preoperative digital imaging can provide a reasonable expectation for patients undergoing secondary rhinoplasty. However, digital imaging must be used with caution, as secondary rhinoplasty patients have heightened expectations and unknown anatomy from their previous operation. The nasal tip and dorsum are especially difficult to adequately predict, and this should be discussed with the patient before surgery.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
鼻整形术仍是整形外科中最常进行的手术之一。关于二次鼻整形术中影像学的应用，人们了解甚少。二次鼻整形术比初次鼻整形术复杂得多。本研究的目的是评估软件成像在接受二次鼻整形术患者中的作用。
进行回顾性研究，以确定2000年1月至2013年8月由资深作者（R.J.R.）进行二次鼻整形术的患者。连续40例患者符合纳入标准。与术前照片和软件成像相比，使用分级量表对改善程度进行分级。
共有40例患者符合纳入标准。其中女性35例（87.5%），男性5例（12.5%）。两名观察者之间对鼻背的平均评分为2.36，鼻中段平均评分为2.65，鼻尖平均评分为2.27，鼻翼平均评分为2.63，鼻基底平均评分为2.99。结论：基于本研究结果，作者确定术前数字成像可为接受二次鼻整形术的患者提供合理预期。然而，数字成像必须谨慎使用，因为二次鼻整形术患者期望较高，且由于之前的手术，其解剖结构不明。鼻尖和鼻背尤其难以充分预测，术前应与患者进行讨论。
临床问题/证据级别：治疗性，四级。
