Uppal Rajan, Yousif Ali H, Maheshwari Kavish
Department of Plastic and Reconstructive Surgery, Wexham Park Hospital and Uppal Plastic Surgery Clinic, London, United Kingdom.
Department of Plastic and Reconstructive Surgery, Bedford Hospital NHS Trust, Bedford, United Kingdom.
Plast Reconstr Surg Glob Open. 2020 Jul 27;8(7):e3001. doi: 10.1097/GOX.0000000000003001. eCollection 2020 Jul.
The columella is an underrepresented part of rhinoplasty. The objective of this study was to assess the outcome of columella correction following rhinoplasty and to assess any differences in the open and endonasal approach.
This is a retrospective study involving 65 rhinoplasty patients, who were divided into 2 groups depending on whether they had an open or endonasal approach. Fifteen patients underwent the open procedure, and 50 patients underwent the endonasal approach. Patients who underwent endonasal rhinoplasty were compared with open rhinoplasty patients in terms of their final outcome, with a focus on the columellar correction. The classification by Rohrich and Liu and Gunter's distance between the nasal axis and columella were used to assess the correction.
The overall incidence of columellar correction was 90% in the endonasal group (45 of 50 patients) and 67% in the open approach group (10 of 15 patients); a comparison shows a value of 0.043 (<0.05). An estimated 49 of 50 patients (98%) from the endonasal group saw a reduction in the nasal axis-columella distance when compared with the open rhinoplasty group, who saw a reduction in 12 of 15 patients (80%); statistical analysis shows a value of 0.036 (<0.05). The quantitative reduction in this distance in all patients when compared between the 2 groups had a value of <0.001, suggesting a greater overall reduction using the endonasal approach. This may be related to differences in distribution of the deformities within the 2 groups.
There is no standard way to correct the columella, but it is important to identify the deformity and the need to correct it. In our patients, we found comparable outcomes in achieving a satisfactory columella in the open and endonasal groups.
鼻小柱在鼻整形术中是一个研究较少的部位。本研究的目的是评估鼻整形术后鼻小柱矫正的效果，并评估开放式和鼻内入路之间的差异。
这是一项回顾性研究，涉及65例鼻整形患者，根据手术采用开放式还是鼻内入路分为两组。15例患者接受开放式手术，50例患者接受鼻内入路手术。将接受鼻内鼻整形术的患者与开放式鼻整形术患者的最终结果进行比较，重点是鼻小柱矫正。采用Rohrich和Liu的分类方法以及Gunter提出的鼻轴与鼻小柱之间的距离来评估矫正情况。
鼻内入路组鼻小柱矫正的总体发生率为90%（50例患者中的45例），开放式入路组为67%（15例患者中的10例）；比较显示P值为0.043（<0.05）。与开放式鼻整形术组相比，鼻内入路组估计50例患者中有49例（98%）鼻轴-鼻小柱距离减小，开放式鼻整形术组15例患者中有12例（80%）减小；统计分析显示P值为0.036（<0.05）。两组患者之间该距离的定量减小P值<0.001，表明鼻内入路总体减小幅度更大。这可能与两组畸形分布的差异有关。
目前尚无矫正鼻小柱的标准方法，但识别畸形及矫正需求很重要。在我们的患者中，我们发现开放式和鼻内入路组在实现满意鼻小柱方面的效果相当。
