Department of Otorhinolaryngology, University Hospital Ulm, Ulm, Germany.
Am J Rhinol Allergy. 2021 Sep;35(5):615-623. doi: 10.1177/1945892420983116. Epub 2020 Dec 22.
Numerous techniques for correction of deviated noses have been described. Nevertheless, surgical management is challenging even for experienced rhinosurgeons. Often, a "residual deformity" after functional septorhinoplasty (SRP) due to a deviated pyramid syndrome may remain.
Therefore, the purpose of this study was to determine how frequent functional SRP in patients with a deviated nose results in "successful" straightening of the external nose based on standardized angle measurements. Possible influences having a positive or negative effect on the surgical success were identified.
Photo documentation of 607 patients with deviated noses (304 women, 303 men, median age 30 years) before and after nasal surgery were retrospectively analyzed using standardized angle measurements. The pre- and postoperative photos of the faces were anthropometrically measured. The median follow-up was 6 months.
A "straight" deviated nose (I-type) was present in 225 patients (37%), a C-shaped nose (C-type) in 382 patients (63%). More than 75% of the patients presented a facial asymmetry. Based on angle measurements alone, a total of 452 (75%) noses were straightened or postoperatively improved. 155 noses (25%) still showed a biometric deviation. The I- or C-type had no relevant influence on outcome.
A purely biometric analysis of crooked noses is difficult and its importance is limited due to commonly pre-existing facial asymmetries. The risk of a "residual deviation" after rhinoplasty in patients with deviated noses must not be underestimated. This fact should be addressed as part of the informed consent. In particular, it should be mentioned that the surgical outcome can remain well below the patient's aesthetic expectations. Not rarely, a revision surgery may be necessary.
已经描述了许多用于矫正偏斜鼻子的技术。然而，即使对于经验丰富的鼻科医生来说，手术管理也具有挑战性。通常，由于偏斜的金字塔综合征，功能性鼻中隔成形术（SRP）后可能仍会残留“畸形”。
因此，本研究的目的是确定在偏斜鼻子的患者中，基于标准化角度测量，功能性 SRP 导致“成功”矫正外鼻的频率。确定对手术成功有积极或负面影响的可能影响因素。
回顾性分析了 607 例偏斜鼻患者（304 名女性，303 名男性，中位年龄 30 岁）的鼻手术后照片，使用标准化角度测量。对术前和术后的面部照片进行了人体测量学测量。中位随访时间为 6 个月。
225 例（37%）患者存在“直”偏斜鼻（I 型），382 例（63%）患者存在 C 型鼻。超过 75%的患者存在面部不对称。仅根据角度测量，共有 452 例（75%）鼻子变直或术后改善。155 例（25%）仍存在生物测量偏差。I 型或 C 型对结果无相关影响。
由于普遍存在的面部不对称，单纯对弯曲的鼻子进行生物计量分析是困难的，其重要性也受到限制。在偏斜鼻患者的鼻整形术后，不应低估“残留偏斜”的风险。这一事实应作为知情同意的一部分加以说明。特别是应该提到，手术结果可能远低于患者的审美期望。并非罕见的是，可能需要进行修正手术。
