McKinney P W, Mossie R D, Bailey M H
Division of Plastic, Reconstructive and Maxillofacial Surgery, Northwestern University, Chicago, Illinois 60611.
Aesthetic Plast Surg. 1988 May;12(2):71-5. doi: 10.1007/BF01576917.
Conflicting guidelines for excisions about the alar base led us to develop calibrated alar base excision, a modification of Weir's approach. In approximately 20% of 1500 rhinoplasties this technique was utilized as a final step. Of these patients, 95% had lateral wall excess ("tall nostrils"), 2% had nostril floor excess ("wide nostrils"), 2% had a combination of these ("tall-wide nostrils"), and 1% had thick nostril rims. Lateral wall excess length is corrected by a truncated crescent excision of the lateral wall above the alar crease. Nasal floor excess is improved by an excision of the nasal sill. Combination noses (e.g., tall-wide) are approached with a combination alar base excision. Finally, noses with thick rims are improved with diamond excision. Closure of the excision is accomplished with fine simple external sutures. Electrocautery is unnecessary and deep sutures are utilized only in wide noses. Few complications were noted. Benefits of this approach include straightforward surgical guidelines, a natural-appearing correction, avoidance of notching or obvious scarring, and it is quick and simple.
关于鼻翼基底切除术的指南存在冲突，这促使我们开发了校准鼻翼基底切除术，这是对韦尔方法的一种改进。在1500例鼻整形手术中，约20%的手术将该技术作为最后一步。在这些患者中，95%存在侧壁多余（“高鼻孔”），2%存在鼻底多余（“宽鼻孔”），2%同时存在这两种情况（“高宽鼻孔”），1%存在厚鼻翼缘。通过在鼻翼沟上方截断外侧壁的新月形切除术来纠正侧壁多余长度。通过切除鼻槛来改善鼻底多余情况。对于复合型鼻子（如高宽型），采用联合鼻翼基底切除术。最后，对于鼻翼缘厚的鼻子，采用菱形切除术来改善。切除术后的缝合采用精细的简单外部缝线。无需电灼，仅在宽鼻手术中使用深部缝线。观察到的并发症很少。这种方法的优点包括手术指南简单明了、矫正效果自然、避免切迹或明显瘢痕形成，而且快速简便。
