Choi Jong Woo, Suh Young Chul, Song Shin Young, Jeong Woo Shik
Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic-ro 43 gil, Songpa-gu, Seoul, 05505, Republic of Korea.
Aesthetic Plast Surg. 2017 Jun;41(3):608-617. doi: 10.1007/s00266-017-0832-0. Epub 2017 Mar 9.
Regarding septal fixation in nasal tip plasty, the nasal tip tripod theory may require modification. We performed three-dimensional (3D) photogrammetric analysis of the "Skiff graft," which is a quadripod method involving folded conchal cartilages fixated on the caudal septal angle, paired lateral crura reinforced by a derotational conchal cartilage graft, and conjoined medial crus on the columella base. We assessed the efficacy of the Skiff graft in maintaining tip projection and preventing cephalic rotation of the nasal tip.
In total, 39 patients who underwent nasal tip plasty with the Skiff graft during 2012-2015 and underwent 3D photogrammetry before (T0), immediately postoperatively (T1, average of 1 week postoperatively), and an average of 215 days postoperatively (T2) were included. Nasal tip projection was objectively measured from images using a software program.
The average differences between the T0 and T1, T0 and T2, and T1 and T2 lengths were 4.81, 3.57, and 0.85 mm, respectively. Thus, 81% of the change in tip projection length that had been achieved immediately postoperatively was maintained at T2 based on 3D photogrammetry (P < 0.001). The relapse ratio of the examined technique was 19.26% (mean, 0.85 mm; P < 0.001).
Nasal tip plasty with the Skiff graft preserves septal support and is an effective primary and revision rhinoplasty technique in Asian patients. This approach may be suitable as an alternative to nasal tip plasty with the septal extension graft in terms of maintaining nasal tip projection, rotational controllability, and nasal mobility.
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关于鼻尖整形术中鼻中隔固定，鼻尖三脚架理论可能需要修正。我们对“斯基夫移植物”进行了三维（3D）摄影测量分析，这是一种四边形方法，包括将折叠的耳甲软骨固定于鼻中隔尾侧角、通过旋转耳甲软骨移植物加强的双侧外侧脚以及鼻小柱基部相连的内侧脚。我们评估了斯基夫移植物在维持鼻尖突出度和防止鼻尖头侧旋转方面的效果。
总共纳入了39例在2012年至2015年期间接受了斯基夫移植物鼻尖整形术的患者，这些患者在术前（T0）、术后即刻（T1，术后平均1周）以及术后平均215天（T2）接受了3D摄影测量。使用软件程序从图像中客观测量鼻尖突出度。
T0与T1、T0与T2以及T1与T2长度的平均差异分别为4.81、3.57和0.85毫米。因此，基于3D摄影测量，术后即刻实现的鼻尖突出度长度变化的81%在T2时得以维持（P < 0.００１）。所检查技术的复发率为19.26%（平均，0.85毫米；P < 0.００１）。
采用斯基夫移植物的鼻尖整形术保留了鼻中隔支撑，是亚洲患者有效的初次和修复性鼻整形技术。就维持鼻尖突出度、旋转可控性和鼻活动度而言，这种方法可能适合作为鼻中隔延伸移植物鼻尖整形术的替代方法。
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