Rudy Shannon, Moubayed Sami P, Most Sam P
Department of Otolaryngology, Stanford University School of Medicine, Stanford, California.
Facial Plast Surg. 2017 Apr;33(2):133-138. doi: 10.1055/s-0036-1598016. Epub 2017 Apr 7.
The nasal midvault is an important consideration in rhinoplasty. This region is defined by the attachment of the upper lateral cartilages (ULCs) to the nasal bones superiorly and the cartilaginous septum medially. Inadequate management of the nasal midvault can have negative functional and aesthetic ramifications. Indications for midvault reconstruction in primary rhinoplasty include a narrow midvault, dorsal hump resection, a deviated midvault, and an asymmetric midvault, with an additional relative indication of zone 1 lateral wall insufficiency (LWI), defined as dynamic collapse of a weakened lateral nasal wall at the level of the ULC. Numerous techniques for midvault reconstruction have been described, dating back to Sheen's description of the spreader graft in the 1980s, which remains the gold standard for repair. Herein, the various indications for midvault reconstruction are described, along with a discussion of the most commonly used techniques for successful reconstruction.
鼻中段穹窿是鼻整形术中的一个重要考量因素。该区域由上方外侧软骨（ULC）与鼻骨的附着以及内侧的鼻中隔所界定。对鼻中段穹窿处理不当会产生负面的功能和美学影响。初次鼻整形术中中段穹窿重建的适应证包括中段穹窿狭窄、鼻背驼峰切除、中段穹窿偏斜和中段穹窿不对称，另外还有1区侧壁不足（LWI）这一相对适应证，其定义为在ULC水平处薄弱的鼻侧壁动态塌陷。自20世纪80年代Sheen描述撑开移植物以来，已经有许多中段穹窿重建技术被描述，撑开移植物仍然是修复的金标准。本文描述了中段穹窿重建的各种适应证，并讨论了成功重建最常用的技术。
