From Iran University of Medical Sciences, St. Fatima Hospital and Burn Research Center; and Shahid Beheshty University of Medical Sciences, Loghman Hakim Hospital.
Plast Reconstr Surg. 2020 Jun;145(6):1410-1417. doi: 10.1097/PRS.0000000000006815.
Middle vault asymmetry is a common reason for retained postoperative deviations. Although minor deformities can be camouflaged with cartilage, soft-tissue materials, or injectable fillers, comprehensive observation of upper lateral cartilage and subsequent topographic classification in major anatomical anomalies will help surgeons better plan their procedures to obtain better symmetry.
Photographs of 71 randomly selected primary open rhinoplasty patients were analyzed for anatomical presentation of their upper lateral cartilage. Photographs were taken before and after separation of upper lateral cartilage from the septum. Upper lateral cartilage was classified from class I to class V according to the width of the transverse subunits and curvature of the vertical subunits.
The authors observed 142 upper lateral cartilages of 71 rhinoplasty patients. Upper lateral cartilage was classified as follows: class I, 53 cases; class II, three cases; class III, 40 cases; class IV, 36 cases; and class V, 10 cases.
Upper lateral cartilage asymmetry is a common occurrence in rhinoplasty, and the upper lateral cartilage itself may be the source of nasal deviation. The middle vault requires special attention, and establishment of a classification system could enable surgeons to devise an effective plan for correction and prevention of retained postoperative nasal deviation.
中隔穹窿不对称是术后仍存在偏斜的常见原因。虽然较小的畸形可以通过软骨、软组织材料或注射填充剂来掩盖，但对外侧软骨的全面观察和随后对主要解剖异常的地形分类，将有助于外科医生更好地规划手术，以获得更好的对称性。
对 71 例随机选择的初次开放式鼻整形术患者的照片进行分析，以了解其外侧软骨的解剖表现。在分离上外侧软骨与鼻中隔之前和之后拍摄照片。根据横向亚单位的宽度和垂直亚单位的曲率，将外侧软骨分为 I 类至 V 类。
作者观察了 71 例鼻整形术患者的 142 个外侧软骨。外侧软骨的分类如下：I 类，53 例；II 类，3 例；III 类，40 例；IV 类，36 例；V 类，10 例。
外侧软骨不对称在鼻整形术中很常见，外侧软骨本身可能是导致鼻偏斜的原因。中隔穹窿需要特别注意，建立一个分类系统可以使外科医生设计出一种有效的矫正和预防术后鼻中隔偏曲的方案。
