Choi Jong Woo, Kim Min Ji, 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. 2018 Dec;42(6):1625-1634. doi: 10.1007/s00266-018-1207-x. Epub 2018 Aug 10.
A severely crooked nose due to trauma or other causes is difficult to correct. Although various nasal osteotomy techniques have been suggested, satisfactory outcomes have not always been achieved especially in centrally deviated noses. Definite correction of the midline and shape of the bony framework is necessary. We aimed to investigate a novel one-piece nasal bone osteotomy approach consisting of transverse osteotomy continued with bilateral lateral osteotomies for the correction of a centrally deviated nose.
This retrospective chart review included 66 consecutive patients who underwent corrective rhinoplasty with nasal bone osteotomy for a deviated nose. Group 1 was treated with one-piece osteotomy, and group 2 was treated with conventional lateral and/or medial osteotomy. Available preoperative and postoperative three-dimensional facial bone computed tomography images were used to quantify nasal landmarks through three-dimensional reconstruction. Patient satisfaction was evaluated using a rhinoplasty outcome evaluation questionnaire.
Measurements of nasal landmark angles toward the longitudinal facial midline plane showed a statistically narrowed postoperative angle in group 1 (subnasale landmark: preoperative angle 1.66 ± 0.29° [group 1] vs. 0.76 ± 1.09° [group 2]; postoperative angle 0.96 ± 0.77° [group 1] vs. 0.31 ± 0.29° [group 2]). The questionnaire scores revealed higher satisfaction (3.11 ± 2.38 vs. 1.157 ± 1.147) and a higher proportion of 4-point scores in group 1.
This is the first study to introduce the one-piece nasal osteotomy technique for centrally deviated noses. The technique consists of transverse osteotomy with bilateral osteotomies in one stage, thus the name "one-piece." Considering anatomic variances in Asian rhinoplasty, a deviated nose should be effectively corrected to obtain satisfactory outcomes. We demonstrated the efficacy and satisfactory outcomes of this new technique.
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因外伤或其他原因导致的严重歪鼻难以矫正。尽管已经提出了各种鼻骨截骨技术，但尤其是在鼻中隔偏曲的鼻子中，并不总能取得令人满意的效果。明确矫正鼻骨框架的中线和形状是必要的。我们旨在研究一种新颖的一体式鼻骨截骨方法，该方法包括横向截骨并延续双侧外侧截骨，用于矫正鼻中隔偏曲的鼻子。
这项回顾性图表审查纳入了66例连续接受鼻骨截骨矫正歪鼻的鼻整形手术患者。第1组采用一体式截骨治疗，第2组采用传统的外侧和/或内侧截骨治疗。利用术前和术后可用的三维面部骨计算机断层扫描图像，通过三维重建对鼻标志点进行量化。使用鼻整形手术结果评估问卷对患者满意度进行评估。
测量鼻标志点朝向面部纵向中线平面的角度显示，第1组术后角度在统计学上变窄（鼻下点标志：术前角度，第1组为1.66±0.29°，第2组为0.76±1.09°；术后角度，第1组为0.96±0.77°，第2组为0.31±0.29°）。问卷评分显示第1组满意度更高（3.11±2.38对1.157±1.147），且4分评分的比例更高。
这是第一项介绍用于鼻中隔偏曲鼻子的一体式鼻骨截骨技术的研究。该技术包括在一个阶段进行横向截骨和双侧截骨，因此称为“一体式”。考虑到亚洲鼻整形中的解剖变异，应有效矫正歪鼻以获得满意的效果。我们证明了这项新技术的有效性和令人满意的结果。
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