Robotti E
Dept of Plastic Surgery, Ospedale Papa Giovanni XXIIII, Piazza OMS 1, 24127, Bergamo, Italy.
HNO. 2018 Feb;66(2):92-102. doi: 10.1007/s00106-017-0425-x.
Shaping a proper dorsum must constitute an essential part of rhinoplasty. This article addresses the main current concepts that play a significant role in dorsal modifications: proper exposure at the keystone, component separation and incremental reduction, straightening the septum and positioning it in the midline, mobilizing and reshaping the nasal bones by osteotomies and osteoplasties, and finally reconstituting a barrel vault of appropriate width and proper contour. The importance of power tools and piezoelectric instrumentation is highlighted, as well as the relevance of simulation and computed tomography (CT) imaging as key to bone and septal work. Finally, the key principles of rebuilding the dorsum in revision rhinoplasty are detailed.
塑造合适的鼻背必须是鼻整形术的重要组成部分。本文阐述了目前在鼻背塑形中起重要作用的主要概念：在关键部位进行适当暴露、成分分离和逐步缩减、鼻中隔矫正并将其置于中线、通过截骨术和骨成形术移动和重塑鼻骨，最后重建具有合适宽度和轮廓的鼻背穹隆。强调了电动工具和压电器械的重要性，以及模拟和计算机断层扫描（CT）成像作为骨骼和鼻中隔手术关键的相关性。最后，详细介绍了鼻整形修复术中重建鼻背的关键原则。
