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短缩及漂浮鼻小柱支撑移植物和鼻中隔鼻小柱缝合对原发性开放式鼻整形术中鼻尖突出度和旋转度的影响

The Effect of the Short and Floating Columellar Strut Graft and Septocolumellar Suture on Nasal Tip Projection and Rotation in Primary Open Approach Rhinoplasty.

作者信息

Şirinoğlu Hakan

机构信息

Department of Plastic Reconstructive and Aesthetic Surgery, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Kartal, Istanbul, Turkey.

出版信息

Aesthetic Plast Surg. 2017 Feb;41(1):146-152. doi: 10.1007/s00266-016-0727-5. Epub 2016 Dec 28.

Abstract

OBJECTIVE

The maintenance of desired tip projection and rotation is an important goal in rhinoplasty. In this study, the effects of the columellar strut graft and septocolumellar sutures were evaluated in a follow-up period of 1 year.

PATIENTS AND METHODS

In half of 44 patients, nasal tip was constructed with basic tip maneuvers and two septocolumellar sutures (Group-1, Suture Group), whereas in the remaining 22 patients, a columellar strut graft was added for tip support (Group-2, Suture + Graft Group). Standardized right profile images were taken preoperatively, 1 month postoperatively and 1 year postoperatively. Nasal tip projection was evaluated using Goode's method. For the evaluation of tip rotation, the nasolabial angle was measured. The results were statistically compared, and a p value lower than 0.05 was considered as significant.

RESULTS

Between the postoperative first month to first year, the loss of tip projection was 3.8% in Group-1 and 3.5% in Group-2 which was statistically insignificant (p value 0.942). The loss of tip rotation was found as 4.6° (4.1%) in Group-1 and 4.6° (4.0%) in Group-2 which was also statistically insignificant (p value 0.979).

CONCLUSIONS

Considering the results of the study, in most of the primary cases, two septocolumellar sutures in conjunction with basic tip maneuvers are sufficient for positioning and stabilizing of the nasal tip, and a short and floating columellar strut graft does not have any affect in maintenance of the desired nasal tip rotation and projection.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the A3 online Instructions to Authors. www.springer.com/00266 .

摘要

目的

维持理想的鼻尖突出度和旋转度是鼻整形术的一个重要目标。在本研究中,对鼻中隔支柱移植和鼻中隔-鼻小柱缝合在1年随访期内的效果进行了评估。

患者与方法

44例患者中,一半采用基本鼻尖手术操作和两根鼻中隔-鼻小柱缝合构建鼻尖(第1组,缝合组),而其余22例患者则添加鼻中隔支柱移植以支撑鼻尖(第2组,缝合+移植组)。术前、术后1个月和术后1年拍摄标准化的右侧位图像。采用古德法评估鼻尖突出度。为评估鼻尖旋转度,测量鼻唇角。对结果进行统计学比较,p值低于0.05被认为具有显著性。

结果

术后第1个月至第1年,第1组鼻尖突出度的丢失率为3.8%,第2组为3.5%,差异无统计学意义(p值0.942)。第1组鼻尖旋转度的丢失为4.6°(4.1%),第2组为4.6°(4.0%),差异也无统计学意义(p值0.979)。

结论

考虑到本研究结果,在大多数初治病例中,两根鼻中隔-鼻小柱缝合结合基本鼻尖手术操作足以定位和稳定鼻尖,短而游离的鼻中隔支柱移植对维持理想的鼻尖旋转度和突出度没有任何影响。

证据水平III:本刊要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述,请参阅目录或A3在线作者指南。www.springer.com/00266

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