Mangialardi Maria Lucia, Baldelli Ilaria, Salgarello Marzia, Raposio Edoardo
Dipartimento Scienze della Salute della Donna e del Bambino, Istituto di Clinica Chirurgica, Università Cattolica del Sacro Cuore e Unità di Chirurgia Plastica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Clinica di Chirurgia Plastica e Ricostruttiva, Ospedale Policlinico San Martino e Sezione di Chirurgia Plastica, Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate (DISC), Università degli Studi di Genova, Genova, Italy.
Plast Reconstr Surg Glob Open. 2020 Jul 27;8(7):e2971. doi: 10.1097/GOX.0000000000002971. eCollection 2020 Jul.
Nipple inversion is a common pathologic condition affecting 2%-10% of women. Congenital inversions are the most common forms, while acquired inversions are less frequent. This condition can induce psychological discomfort, functional problems that could prevent adequate breast feeding, and cosmetic dissatisfaction, and create local irritation and infection. The aim of this article was to provide a comprehensive review of the literature about surgical treatment of inverted nipple.
A literature search was conducted by using PubMed, Google Scholar, and Cochrane database using the following MeSH terms: "inverted nipple," "inverted nipple surgery," "inverted nipple treatment," and "inverted nipple management." Studies that described surgical treatment and included outcomes and recurrence rate were included.
Thirty-three articles were considered suitable, including 3369 inverted nipple cases. Eight studies described techniques with lactiferous ducts damaging, while 25 studies described techniques with lactiferous duct preservation using dermal flaps, sutures, or distractor systems. The average follow-up was 23.9 months. Overall, a satisfactory correction was reached in 88.6% of cases, and the recurrence rate was 3.89%.
To our knowledge, our review includes the largest sample size in the literature. The heterogeneity and subjectivity of outcomes make it more complicated to state which is the best surgical strategy to adopt to obtain satisfactory and stable results with minimal morbidity. This study highlights the need of a standardized method to evaluate outcomes, including aesthetic, functional and psychological results, while using objective and subjective measurement instruments.
乳头内陷是一种常见的病理状况，影响2% - 10%的女性。先天性乳头内陷是最常见的类型，而获得性乳头内陷则较为少见。这种情况可引起心理不适、导致妨碍充分母乳喂养的功能问题、造成美容方面的不满，并引发局部刺激和感染。本文的目的是对乳头内陷手术治疗的文献进行全面综述。
通过使用PubMed、谷歌学术和Cochrane数据库进行文献检索，使用以下医学主题词：“乳头内陷”、“乳头内陷手术”、“乳头内陷治疗”和“乳头内陷处理”。纳入描述手术治疗并包括结果和复发率的研究。
33篇文章被认为合适，包括3369例乳头内陷病例。8项研究描述了损伤输乳管的技术，而25项研究描述了使用皮瓣、缝线或牵引系统保留输乳管的技术。平均随访时间为23.9个月。总体而言，88.6%的病例获得了满意的矫正，复发率为3.89%。
据我们所知，我们的综述纳入了文献中最大的样本量。结果的异质性和主观性使得很难说明采用哪种最佳手术策略能以最小的发病率获得满意和稳定的结果。本研究强调需要一种标准化方法来评估结果，包括美学、功能和心理结果，同时使用客观和主观测量工具。
