Stenner Markus, Koopmann Mario, Rudack Claudia
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Münster, Kardinal-von-Galen-Ring 10, 48149, Münster, Germany.
Eur Arch Otorhinolaryngol. 2017 Feb;274(2):855-860. doi: 10.1007/s00405-016-4296-7. Epub 2016 Sep 15.
Although septorhinoplasty is the most commonly performed operation in plastic surgery, and the surgical plan as well as its outcome is directly related to the configuration of the anatomical structures in the nose, these are not routinely assessed preoperatively. The aim of our study was to evaluate the nasal soft tissue and cartilaginous structures by means of high-resolution ultrasonography to set up clinical correlations and standard values. We examined 44 patients before septorhinoplasty by high-resolution ultrasonography in noncontact mode. All pictures were quantitatively evaluated by measuring 13 lengths and 4 ratios. All patients underwent a rhinomanometry measuring the nasal air flow. Besides others, men as well as older patients have a significantly thicker alar cartilage. Patients with thinner alar cartilages have a significantly smaller interdomal distance as well as significantly thinner upper lateral cartilages. The soft tissue above the bony dorsum was significantly thicker in older patients. Younger patients have significantly thicker soft tissue in relation to their cartilage. Patients with thicker soft tissue and thinner cartilage have a smaller tip. The interdomal distance and the thickness of the cartilaginous septum significantly correlated with the nasal air flow. We set up standard values of nasal structures in septorhinoplasty patients which can be used as reference values. By judging cartilage and soft tissue characteristics preoperatively, relevant factors for distinct procedures could be analyzed and the surgical steps can be better planned. Visualization by ultrasonography enables the surgeon to achieve treatment goals in a more predictable fashion.
尽管鼻中隔成形术是整形外科中最常开展的手术，且手术方案及其效果与鼻部解剖结构的形态直接相关，但术前通常不会对这些结构进行评估。我们研究的目的是通过高分辨率超声评估鼻部软组织和软骨结构，以建立临床相关性和标准值。我们在非接触模式下通过高分辨率超声对44例鼻中隔成形术患者进行了术前检查。所有图像均通过测量13个长度和4个比例进行定量评估。所有患者均接受了测量鼻气流的鼻阻力测量。除此之外，男性以及老年患者的鼻翼软骨明显更厚。鼻翼软骨较薄的患者，其鼻尖间距明显更小，上外侧软骨也明显更薄。老年患者鼻骨背侧上方的软组织明显更厚。年轻患者相对于其软骨而言，软组织明显更厚。软组织较厚而软骨较薄的患者鼻尖较小。鼻尖间距和鼻中隔软骨厚度与鼻气流显著相关。我们建立了鼻中隔成形术患者鼻部结构的标准值，可作为参考值。通过术前判断软骨和软组织特征，可以分析不同手术的相关因素，并更好地规划手术步骤。超声成像使外科医生能够以更可预测的方式实现治疗目标。
