Sirin Ali Ahmet, Erdim Ibrahim, Erdur Omer, Sirin Alperen
Uzmanlar Health Center, Istanbul, Turkey.
Medical Faculty, Gaziosmanpasa University, Kaleardı Mahallesi Muhittin Fisunoğlu Caddesi Ali Şevki EREK Yerleşkesi, 60100, Tokat, Turkey.
Aesthetic Plast Surg. 2018 Apr;42(2):577-589. doi: 10.1007/s00266-017-0999-4. Epub 2017 Nov 9.
In modern rhinoplasty, septal cartilage is the most commonly used graft material. It is a big challenge if septal cartilage is insufficient. We present an alternative technique named the "rabbit flap," created from the cephalic portion of the lower lateral cartilage to show its effectiveness on nasolabial angle, nasal axis deviation, and nasal dorsal line.
An alternative flap, called a "rabbit flap," is constituted from the cephalic portion of the lower lateral cartilage (LLC). The key for this flap's success is in not cutting the connection between the lateral and medial crus of the alar cartilage. The flap is rotated and placed between the upper lateral cartilage and the septum to ensure a spreader graft effect; it can also be moved forward and backward to adjust the nasal tip rotation. Patients whose minimum width of LLC was 12 mm were included in this study. We subjectively evaluated the results of this technique for 24 patients who completed the rhinoplasty outcomes evaluation (ROE) questionnaire and objectively by measuring the nasal axis and nasolabial angles in the preoperative and postoperative first-year periods.
There were significant improvements in ROE, nasal axis deviation, and nasolabial angle scores when preoperative and postoperative first-year controls were compared (p < 0.001). We also observed no complications.
With this technique, we can correct both a nasal tip rotation and a mild nasal axis deviation. Moreover, we can achieve a proper nasal dorsal line and prevent an inverted V deformity. By expanding the internal nasal valve, a functionally effective surgery can be performed. However, the LLC must be strong enough to avoid alar collapse. In light of our results, we believe that the technique we call the "rabbit flap" can be used as an alternative rhinoplasty technique.
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 online Instructions to Authors www.springer.com/00266 .
在现代鼻整形术中，鼻中隔软骨是最常用的移植材料。如果鼻中隔软骨不足，将是一个巨大的挑战。我们提出一种名为“兔瓣”的替代技术，该技术由下外侧软骨的头部部分构建而成，以展示其在鼻唇角、鼻轴偏斜和鼻背线方面的有效性。
一种名为“兔瓣”的替代皮瓣由下外侧软骨（LLC）的头部部分构成。该皮瓣成功的关键在于不切断鼻翼软骨外侧脚和内侧脚之间的连接。将皮瓣旋转并置于上外侧软骨和鼻中隔之间，以确保起到撑开移植片的作用；它还可以前后移动以调整鼻尖旋转。本研究纳入了LLC最小宽度为12毫米的患者。我们对24名完成鼻整形术结果评估（ROE）问卷的患者的该技术结果进行了主观评估，并通过测量术前和术后第一年的鼻轴和鼻唇角进行了客观评估。
将术前和术后第一年的对照进行比较时，ROE、鼻轴偏斜和鼻唇角评分有显著改善（p < 0.001）。我们也未观察到并发症。
通过该技术，我们可以纠正鼻尖旋转和轻度鼻轴偏斜。此外，我们可以实现合适的鼻背线并防止倒V畸形。通过扩大鼻内瓣膜，可以进行功能有效的手术。然而，LLC必须足够强壮以避免鼻翼塌陷。根据我们的结果，我们认为我们所称的“兔瓣”技术可作为一种替代的鼻整形技术。
证据等级IV：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266 。
