Department of Otorrinolaringology, Mater Dei Rede de Saúde, Belo Horizonte, Minas Gerais, Brazil.
Department of Facial Plastic Surgery, Marien Hospital Stuttgart, Stuttgart, Baden-Württemberg, Germany.
Facial Plast Surg. 2021 Oct;37(5):666-672. doi: 10.1055/s-0041-1726025. Epub 2021 Apr 14.
Here we describe a new technique to deal with alar retraction, a highly undesirable imperfection of the nose. The procedure involves placing a caudal extension graft below the vestibular portion of the lower lateral cartilage (LLC) after its detachment from the vestibular skin. The graft is fixed to the cartilage and, subsequently, to the vestibular tissue. The present retrospective study included 20 patients, 11 females and 9 males, with a mean age of 28.90 years. Follow-up ranged from 1 to 18 months. Surgery improved alar notching to a smoother dome shape and nostril exposure was reduced in every patient. The caudal extension graft of the LLC contributed to rise in overall patient satisfaction, as revealed by the postoperative increase of the Rhinoplasty Outcomes Evaluation (ROE) mean score from 40.0 to 79.17 ( < 0.0001). It also contributed to and improved functional outcomes, as indicated by the decrease of the Nasal Obstruction Symptom Evaluation (NOSE) mean score from 52.75 to 13.25 ( = 0.0001). Sex did not affect the mean ROE and NOSE scores. Thus, increased patient satisfaction measured by the ROE is present in both sexes and at both age groups but it is better detected in the first year after surgery. Functional improvements analyzed with NOSE are best detected in patients aged ≥ 30 years and in follow-ups of 11 months. The caudal extension graft of the LLC technique described herein effectively and safely corrects alar retraction and the collapse of the nasal valve while filling the soft triangle.
我们在这里描述了一种处理鼻翼退缩的新技术，鼻翼退缩是鼻子的一种非常不理想的缺陷。该手术包括在外侧下鼻甲（LLC）的前庭部分与前庭皮肤分离后，在下鼻甲的尾部放置一个延伸移植物。移植物固定在软骨上，然后固定在前庭组织上。本回顾性研究包括 20 名患者，11 名女性和 9 名男性，平均年龄为 28.90 岁。随访时间为 1 至 18 个月。手术改善了鼻翼切迹，使鼻翼穹窿更加平滑，并且每个患者的鼻孔暴露都减少了。LLC 的尾部延伸移植物增加了患者的整体满意度，术后 Rhinoplasty Outcomes Evaluation（ROE）平均评分从 40.0 增加到 79.17（ < 0.0001）。它还改善了功能结果，正如 Nasal Obstruction Symptom Evaluation（NOSE）平均评分从 52.75 下降到 13.25（ = 0.0001）所表明的那样。性别不影响 ROE 和 NOSE 评分的平均值。因此，通过 ROE 测量的患者满意度增加在男女两性和两个年龄组中都存在，但在手术后的第一年中检测效果更好。使用 NOSE 分析的功能改善在年龄≥30 岁的患者和 11 个月的随访中检测效果最佳。本文描述的 LLC 尾部延伸移植物技术可以有效地、安全地矫正鼻翼退缩和鼻阀塌陷，同时填充软组织三角。
