Jankowski R, Gallet P, Nguyen D-T, Rumeau C
CHRU-Nancy, ORL et Chirurgie Cervico-Faciale, Hôpitaux de Brabois, Bâtiment Louis Mathieu, Allée du Morvan, 54600 Vandoeuvre les Nancy, France; EA 3450 DevAH-Développement, Adaptation et Handicap, Régulations Cardio-Respiratoires et de la Motricité, Université de Lorraine, Faculté de Médecine de Nancy-Laboratoire de Physiologie, 9 Avenue de la Forêt de Haye, CS 50184, 54505 Vandoeuvre les Nancy, France; NGERE-UMR_S1256, Université de Lorraine, Inserm, NGERE, 54000 Nancy, France.
CHRU-Nancy, ORL et Chirurgie Cervico-Faciale, Hôpitaux de Brabois, Bâtiment Louis Mathieu, Allée du Morvan, 54600 Vandoeuvre les Nancy, France; NGERE-UMR_S1256, Université de Lorraine, Inserm, NGERE, 54000 Nancy, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2020 Nov;137(5):423-426. doi: 10.1016/j.anorl.2020.07.014. Epub 2020 Oct 2.
The difficulty of correcting nasal septum deformities using the classical Killian or Cottle techniques or derivatives has led in recent years to new suggestions such as extracorporeal septoplasty or various apposition grafts to counteract refractory deformity of the quadrangular cartilage. Naturally occurring septal deformities result from conflicts in growth between the quadrangular cartilage, perpendicular ethmoidal plate and vomer, which each have their own different evo-devo origin. Septoplasty by disarticulation consistently restores a level septum by completely resolving the growth conflicts. Conserving the quadrangular cartilage is essential for the stability of the nasal pyramid on condition that 1) the lateral flare of the superior edge of both the component septolateral cartilages that suspend it at the roof of the piriform orifice and 2) the height of its anterior edge are respected. The anterior edge is always high enough (except in case of fracture or malformation to project the retrolobular nasal dorsum in proportion to the height of the alar cartilage when it is repositioned on its natural premaxillary base.
使用经典的基利安或科特尔技术及其衍生技术矫正鼻中隔畸形存在困难，这在近年来催生了一些新的建议，如体外鼻中隔成形术或各种对位移植术，以对抗四边形软骨的难治性畸形。自然发生的鼻中隔畸形是由于四边形软骨、垂直筛骨板和犁骨之间生长冲突导致的，它们各自有着不同的进化发育起源。通过关节离断术进行鼻中隔成形术通过完全解决生长冲突，始终能恢复一个平整的鼻中隔。在满足以下条件时，保留四边形软骨对鼻锥体的稳定性至关重要：1）悬吊于梨状孔顶部的鼻中隔外侧软骨组成部分上缘的外侧扩张；2）其前缘的高度。前缘总是足够高（骨折或畸形情况除外），以便在鼻翼软骨重新定位到其自然的上颌前基底部时，与鼻翼软骨的高度成比例地突出小叶后鼻背。
