From the Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédias Abel Salazar, Faculdade de Medicina da Universidade do Porto, Hospital da Luz, Arrábida; Hospital Militar do Porto; and the Departamento de Engenharia Mecânica, Universidade do Minho.
Plast Reconstr Surg. 2020 Feb;145(2):403-406. doi: 10.1097/PRS.0000000000006512.
Humpectomy is one of the most common steps in reduction rhinoplasty among Caucasian patients. The most widespread procedures to address hump removal are both the "en bloc humpectomy" (with reconstruction of the middle third with spreader grafts) and the "split hump technique" (with confection of spreader flaps). The spare roof technique, for rhinoplasty reduction, has been developed over the past 4 years. In this technique, the upper lateral cartilages are completely preserved-even the hidden part under the caudal aspect of the nasal bones. It consists of five main steps: step 1, the upper lateral cartilages are released from the dorsal aspect of the nasal septum; step 2, a 1-mm strip of the dorsal septum is taken in each movement as required; step 3, ostectomy of the caudal aspect of nasal bones, keeping the upper lateral cartilages intact and releasing the "lateral" (left and right) pyriform aperture ligament; step 4, classic medial and lateral osteotomies (closing the open bony roof); and step 5, suturing the upper lateral cartilages to the dorsal septum and thus avoiding the natural spring effect. The outcomes of the first 100 patients have been validated by a prospective, interventional, and longitudinal study performed on patients undergoing primary rhinoplasty by means of the spare roof technique. This study confirms that the spare roof technique significantly improved patient quality of life regarding nose function and appearance. It is a reliable technique that can help deliver consistently good results in Caucasian and Mediterranean patients with a dorsal hump seeking rhinoplasty.
削骨术是白种人患者缩鼻整形术中最常见的步骤之一。最广泛的去除驼峰的手术是“整块削骨术”（用鼻中隔扩张移植物重建中三分之一）和“分裂驼峰技术”（用鼻中隔扩张皮瓣制作）。在过去的 4 年中，为了进行鼻整形术的缩窄，发展了备用屋顶技术。在这种技术中，上外侧软骨被完全保留-甚至是隐藏在鼻骨尾部下方的部分。它由五个主要步骤组成：第 1 步，上外侧软骨从鼻中隔的背侧释放；第 2 步，在每个动作中都需要从鼻中隔背侧取出 1 毫米的软骨条；第 3 步，进行鼻骨尾部的截骨术，同时保持上外侧软骨完整，并释放“外侧”（左右）梨状孔韧带；第 4 步，进行经典的内侧和外侧截骨术（闭合开放的骨性屋顶）；第 5 步，将上外侧软骨缝合到鼻中隔上，从而避免自然的弹性效应。通过对 100 例首次接受备用屋顶技术的原发性鼻整形术患者进行前瞻性、干预性和纵向研究，验证了前 100 例患者的结果。这项研究证实，备用屋顶技术显著改善了患者的生活质量，包括鼻子的功能和外观。它是一种可靠的技术，可以帮助白种人和地中海人种中寻求鼻整形术的有驼峰的患者始终获得良好的效果。
