ENT Department, Cyprus International University Medical Faculty, Lefkoşe, Cyprus.
Health Sciences Department, Kocaeli Health and Technologies University, European Vocational High School, Kazlıçeşme, Ahmet Haşim Sk. 8/1, 34010, Zeytinburnu, İstanbul, Turkey.
Eur Arch Otorhinolaryngol. 2020 Dec;277(12):3349-3356. doi: 10.1007/s00405-020-06225-y. Epub 2020 Jul 23.
It is important to reinforce nasal tip support for long-term satisfactory results. Two workhorses of tip support are strut grafting and the tongue-in-groove technique. Tongue-in-groove causes retraction and stiffness; the strut causes loss of rotation and projection of tip. We introduced a novel technique that avoids these consequences.
Between February 2018-February 2019, 40 female underwent primary rhinoplasty. Mean age: 27 years (18-41 years).
FOLLOW-UP: 1-2 years. In first group (20 patients), caudal septum was resected and strut was not fixated to caudal septum. In second group (20 patients), tongue-like extension (septal autoextension) was preserved at caudal septum and sutured to strut. Preoperative, peroperative, and postoperative images were compared.
Tip projection ratio calculations, nasolabial angle measurements were evaluated by statistical analyses. The change in projection ratios between peroperative period and 1-year postoperative period of strut-only group was higher than septal autoextension group (p = 0.001). This result indicates that nasal tip projection loss in strut-only group was higher compared to septal autoextension group. The change in nasolabial angle measurements from peroperative period to 1-year postoperative period differed significantly between two groups (p = 0.001). Significant difference was observed between 1-year postoperative nasolabial angle measurements of two groups (p = 0.006); septal autoextension group measurements were higher than strut-only group. These results showed that fixation of strut graft to the septal autoextension provides better preservation of the nasolabial angle and stabilization of nasal tip projection. CONCLUSıON: Fixation of septum and strut graft through septal autoextension provides satisfactory stabilization of tip projection and rotation without stiffness or rigidity.
加强鼻尖支撑对于获得长期满意的效果非常重要。鼻尖支撑的两个主要方法是支撑移植物和榫槽技术。榫槽技术会导致鼻尖回缩和僵硬；支撑移植物会导致鼻尖旋转和突出度丧失。我们引入了一种新的技术来避免这些后果。
在 2018 年 2 月至 2019 年 2 月期间，有 40 名女性接受了初次鼻整形术。平均年龄：27 岁（18-41 岁）。
1-2 年。在第一组（20 例患者）中，切除了鼻中隔尾端，并将支撑物不固定到鼻中隔尾端。在第二组（20 例患者）中，保留了鼻中隔尾端的舌状延伸（鼻中隔自体延伸）并将其缝合到支撑物上。比较了术前、术中、术后的图像。
通过统计分析评估了鼻尖突出率的计算和鼻唇角的测量。在单纯支撑物组中，从手术期间到术后 1 年的鼻尖突出率变化高于鼻中隔自体延伸组（p=0.001）。这一结果表明，与鼻中隔自体延伸组相比，单纯支撑物组的鼻尖突出度丢失更高。从手术期间到术后 1 年的鼻唇角测量值在两组之间的变化有显著差异（p=0.001）。两组术后 1 年的鼻唇角测量值有显著差异（p=0.006）；鼻中隔自体延伸组的测量值高于单纯支撑物组。这些结果表明，通过鼻中隔自体延伸将支撑物固定到鼻中隔上，可以更好地保持鼻唇角并稳定鼻尖突出度。
通过鼻中隔自体延伸将鼻中隔和支撑物固定在一起，可以在不导致僵硬或刚性的情况下，满意地稳定鼻尖的突出度和旋转度。
