Private Practice, Istanbul, Turkey.
Aesthetic Plast Surg. 2020 Jun;44(3):891-901. doi: 10.1007/s00266-020-01660-y. Epub 2020 Mar 4.
Dorsal hump reduction is one of the most frequently performed rhinoplasty operations among white populations. The best method for preserving a natural nasal dorsum and avoiding revision surgery is to perform the push-down technique. The concept of the push-down technique is not new and has been improved over time.
In the present study, the author introduces a new approach for the push-down technique in which there is no need for osteotomy.
According to the inclusion and exclusion criteria, sixty-two patients were included in the present study. All patients who were included in the study were assessed with the Rhinoplasty Outcome Evaluation (ROE) questionnaire at their 1-year follow-up appointment. In the present technique, the superior dorsal cartilage was pushed down to the reverse side of the septal deviation, and the nasal dorsum was rasped with a micromotor rasping machine instead of undergoing osteotomy.
The initial median ROE score was 68.5 points, and the postoperative median score was 90.5 points. A final score greater than 85 was considered excellent and an indication of high patient satisfaction. Among the sixty-two patients, 56 had a score greater than 85 points (90.32%) (p = 0.001). There were no complications, and there was no need for revision surgery.
This push-down technique can be considered an easy and suitable approach for selected patient populations. Additionally, the recovery time is shortened with the push-down technique without osteotomy.
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.
在白种人群中，驼峰减少是最常进行的鼻整形手术之一。保留自然鼻背和避免修复手术的最佳方法是进行推下技术。推下技术的概念并不新鲜，并且随着时间的推移不断得到改进。
本研究作者介绍了一种新的推下技术方法，该方法不需要进行截骨术。
根据纳入和排除标准，本研究纳入了 62 例患者。所有纳入研究的患者均在术后 1 年随访时使用鼻整形术后评估（ROE）问卷进行评估。在本技术中，将上侧鼻软骨推至鼻中隔偏曲的反侧，并用微电机锉刀锉削鼻背，而不是进行截骨术。
初始中位数 ROE 评分为 68.5 分，术后中位数评分为 90.5 分。最终评分大于 85 分被认为是优秀的，表明患者非常满意。在 62 例患者中，56 例评分大于 85 分（90.32%）（p=0.001）。无并发症，无需进行修复手术。
对于选择的患者群体，这种推下技术可以被认为是一种简单且合适的方法。此外，与截骨术相比，推下技术可缩短恢复期。
证据等级 IV：本杂志要求作者为每篇文章分配一个证据等级。有关这些基于证据的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。
