Kopacheva-Barsova Gabriela, Davcheva-Chakar Marina, Nikolovski Nikola, Marolov Marjan, Petreska-Dukovska Vesna
ENT University Clinic, University Campus "St. Mother Theresa", Skopje, Republic of Macedonia.
General Hospital "Remedika", Skopje, Republic of Macedonia.
Open Access Maced J Med Sci. 2019 Dec 13;7(23):4036-4042. doi: 10.3889/oamjms.2019.732. eCollection 2019 Dec 15.
The over projected nose, commonly referred to as the "Pinocchio" nose is a significant challenge to the rhinoplasty surgeon. Firstly, we speak about a very large nose, and secondly, we speak about the correction of nasal cartilages (alar and triangular). Surgical correction of the over projected nose is the most difficult and least predictable component of rhinoplasty surgery.
By performing rhinoseptoplasty we aimed to achieve an ideal landmarks position according to concepts of nasal projection as well as by making preoperative analyses to determine the ideal position for the nasal tip after having understood and defined the ideal position for the nasion.
We performed a retrospective study of patients who were admitted to ENT University Clinic, University Campus "St. Mother Theresa" Skopje, the Republic of Macedonia in the period 2011-2019. A total of 70 patients were enrolled in the study; 46 women (33%) and 24 men (33%). Operative technique rhinoseptoplasty was realised in 70 patients. All of the 70 (100%) patients underwent preoperative and postoperative evaluation during this period regularly to record the effects of various approaches on nasal projection, rotation, need for revision, and patient satisfaction.
All patients used one or more of the preferred methods to treat over projection. Patients who had undergone 2 previous rhino/septoplasty procedures were excluded from the study, and hence, a total of 70 patients were evaluated. Full-transfixion incisions were made in all patients. From 2011 to 2019, in 72 cases, 1 or more of the preferred methods were used to treat over projection.
The crural anatomy of the nasal tip relates to the size and shape of the lower lateral cartilages (LLC) and their relationship with the caudal septum and upper lateral cartilages (ULC). Modification of nasal tip rotation and projection should attempt to preserve or reconstruct major tip mechanisms.
鼻过度突出，通常被称为“匹诺曹”鼻，这对鼻整形外科医生来说是一项重大挑战。首先，我们说的是一个非常大的鼻子，其次，我们说的是鼻软骨（鼻翼和三角软骨）的矫正。鼻过度突出的手术矫正，是鼻整形手术中最困难且最难以预测的部分。
通过进行鼻中隔成形术，我们旨在根据鼻突出的概念实现理想的标志位置，并在理解和确定鼻根的理想位置后，通过术前分析来确定鼻尖的理想位置。
我们对2011年至2019年期间在马其顿共和国斯科普里“圣特蕾莎嬷嬷”大学校园的耳鼻喉科大学诊所收治的患者进行了一项回顾性研究。共有70名患者纳入该研究；46名女性（66%）和24名男性（34%）。70名患者均实施了鼻中隔成形术。在此期间，所有70名（100%）患者均定期接受术前和术后评估，以记录各种方法对鼻突出、旋转、修复需求及患者满意度的影响。
所有患者均采用了一种或多种治疗鼻过度突出的首选方法。曾接受过两次鼻/鼻中隔成形术的患者被排除在研究之外，因此，共评估了70名患者。所有患者均采用了全贯穿切口。2011年至2019年期间，72例患者采用了一种或多种首选方法治疗鼻过度突出。
鼻尖的脚状解剖结构与下外侧软骨（LLC）的大小和形状及其与鼻中隔尾侧和上外侧软骨（ULC）的关系有关。鼻尖旋转和突出的调整应尝试保留或重建主要的鼻尖机制。
