Department of Otolaryngology, Head and Neck Surgery, Otorhinolaryngology Research Center, Vali-Asr Hospital, Imam Khomeini Medical Complex, Tehran University of Medical Sciences, Dr. Gharib Avenue, Keshavarz Boulevard, Tehran, Iran.
Aesthetic Plast Surg. 2019 Feb;43(1):189-195. doi: 10.1007/s00266-018-1252-5. Epub 2018 Oct 4.
The thick-skinned nose is still one of the most challenging aspects of rhinoplasty. The possible effects of oral isotretinoin on cosmetic results of rhinoplasty in patients with thick nasal skin have been considered during recent years.
In this double-blind placebo-controlled clinical trial, 48 cases were divided into two groups randomly. Oral isotretinoin (0.5-mg/kg) was started on the 31st day after surgery and given every other day for 1 month and after that daily for two additional months in the first group. The second group received a placebo in the same form, sequence and interval as the first group. The cosmetic results based on patient satisfaction and ranking by an expert surgeon were compared between the two groups at 3 months, 6 months and 1 year after surgery.
Patient satisfaction and ranking by an expert surgeon in the isotretinoin group at 3 months and 6 months after surgery were significantly better than in the placebo group (p value < 0.05); however, at 12 months after surgery there was no statistically significant difference between the two groups (p value > 0.05).
Though postoperative use of oral isotretinoin in patients with thick nasal skin accelerates improvement in cosmetic results during the early months after surgery, it does not significantly affect the final cosmetic result 1 year after surgery.
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厚皮鼻仍然是鼻整形术最具挑战性的方面之一。近年来，人们已经考虑了口服异维 A 酸对厚鼻皮肤患者鼻整形美容效果的可能影响。
在这项双盲安慰剂对照临床试验中，将 48 例患者随机分为两组。术后第 31 天开始口服异维 A 酸（0.5mg/kg），每两天一次，持续 1 个月，然后在此基础上加用 2 个月，每天一次。第二组以与第一组相同的形式、顺序和间隔给予安慰剂。术后 3、6 和 12 个月比较两组患者满意度和专家外科医生评分的美容效果。
术后 3 个月和 6 个月时，异维 A 酸组患者满意度和专家外科医生评分均明显优于安慰剂组（p 值均<0.05）；然而，术后 12 个月时两组间无统计学差异（p 值均>0.05）。
尽管厚鼻皮肤患者术后使用口服异维 A 酸可加速术后早期美容效果的改善，但对术后 1 年的最终美容效果无显著影响。
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