Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Facial Plast Surg Aesthet Med. 2021 Jan-Feb;23(1):42-48. doi: 10.1089/fpsam.2020.0039. Epub 2020 Jun 4.
Septoplasty is used to correct nasal obstructions caused by a deviated septum. In some patients, septal deviation is also associated with external nasal deformity, which suggests that proper septoplasty can improve external deformities as well. However, objective studies of the esthetic outcome of septoplasty are limited. To investigate the potential esthetic outcome of correction of septal in addition to its functional purpose of treating nasal obstructions. Retrospective chart analysis of prospectively collected data was conducted for patients who underwent septoplasty performed by a single surgeon at our clinic. Ninety-five patients who had preoperative and postoperative medical photographs were enrolled. We measured the mid-vault dorsum angle (MDA) from a bird's eye view to evaluate the objective esthetic outcome. The nasofrontal angle and the nasolabial angle were also included in our analysis. Differences in preoperative anthropometric measurements and application of specific surgical techniques were additionally analyzed. The mean age of the participants was 39.1 years (male: 85.2%, female: 14.8%). The average preoperative MDA was 3.41° ± 3.05°, and the postoperative MDA was 1.88° ± 1.09° ( < 0.001). In the severe dorsum deviation group (MDA >4°, = 31), angle measure improvement was prominent (3.82° ± 2.97°, < 0.001). The correlation analysis revealed that a higher preoperative MDA had a significant correlation with a higher angle improvement postoperatively ( = 0.7, < 0.001); this outcome was also observed in the severe dorsal deviation group ( = 0.6, = 0.003). In addition, we found a positive correlation between the bony septal deviation angle on computed tomography and preoperative MDA ( = 0.51, = 0.003). In some cases with significant external dorsum deviation, septoplasty via an endonasal approach can yield positive esthetic outcomes in addition to functional improvements. This finding will benefit patient counseling and also provide important surgical concepts in rhinoplasty with an emphasis on a gradual surgical approach to correcting external nasal deformity.
鼻中隔成形术用于矫正鼻中隔偏曲引起的鼻腔阻塞。在一些患者中，鼻中隔偏曲也与外部鼻畸形有关，这表明适当的鼻中隔成形术也可以改善外部畸形。然而，关于鼻中隔成形术美学效果的客观研究是有限的。本研究旨在探讨鼻中隔成形术在治疗鼻腔阻塞的功能目的之外的潜在美学效果。对在我院接受单一手术医生行鼻中隔成形术的患者进行前瞻性收集数据的回顾性图表分析。共纳入 95 例术前和术后有医学照片的患者。我们从鸟瞰图测量中隔穹窿背角（MDA）以评估客观美学效果。鼻额角和鼻唇角也包括在我们的分析中。还分析了术前人体测量测量值和特定手术技术应用的差异。参与者的平均年龄为 39.1 岁（男性：85.2%，女性：14.8%）。平均术前 MDA 为 3.41°±3.05°，术后 MDA 为 1.88°±1.09°（ < 0.001）。在严重背侧偏曲组（MDA>4°， = 31）中，角度测量改善明显（3.82°±2.97°， < 0.001）。相关性分析显示，术前 MDA 越高，术后角度改善越大（ = 0.7， < 0.001）；在严重的背侧偏曲组中也观察到了这种结果（ = 0.6， = 0.003）。此外，我们发现 CT 上的骨性鼻中隔偏曲角度与术前 MDA 呈正相关（ = 0.51， = 0.003）。在一些有明显外部背侧偏曲的病例中，经鼻内入路的鼻中隔成形术除了改善功能外，还能获得良好的美学效果。这一发现将有助于患者咨询，并为强调逐步手术方法矫正外部鼻畸形的鼻整形术提供重要的手术概念。
