Garefis K, Konstantinidis I, Tsetsos N, Garefi M, Nikolaidis V, Markou K
2nd Academic ORL, Head and Neck Surgery, Department Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece.
Department of ORL, Head and Neck Surgery, G. Papanikolaou Hospital, Thessaloniki, Greece.
Rhinology. 2022 Apr 1;60(2):92-101. doi: 10.4193/Rhin21.235.
The standard treatment for reconstructing the middle vault of the nose is to use spreader grafts. Recently, an alternative technique using spreader flaps has become widely accepted.
A literature search was performed in MEDLINE, Science Direct, the Cochrane Library and multiple trial registries. The systematic review included studies evaluating the effectiveness of spreader flaps, with or without comparison to the spreader graft technique, in patients who had undergone primary rhinoplasty.
Thirteen studies with a total of 500 patients met the inclusion criteria and were reviewed systematically. All studies measured breathing function improvement. Additionally, aesthetic improvement/satisfaction was evaluated in seven studies. The use of spreader flaps seems to improve breathing function, as seen in twelve out of thirteen studies. Furthermore, the studies assessing the aesthetic aspect of a primary rhinoplasty showed that spreader flaps can provide satisfactory results. The comparison between spreader flaps and spreader grafts showed similar results in most studies dealing with this topic in both the breathing function improvement and aesthetic improvement/satisfaction domains.
This study is the first systematic review assessing the functional and aesthetic outcomes of spreader flaps in primary rhinoplasty, and it shows encouraging results comparable to those of spreader grafts.
重建鼻中段穹窿的标准治疗方法是使用撑开移植物。最近，一种使用撑开皮瓣的替代技术已被广泛接受。
在MEDLINE、科学Direct、Cochrane图书馆和多个试验注册库中进行了文献检索。该系统评价纳入了评估撑开皮瓣在初次鼻整形术中有效性的研究，无论是否与撑开移植物技术进行比较。
13项研究共500例患者符合纳入标准并进行了系统评价。所有研究均测量了呼吸功能的改善情况。此外，7项研究评估了美学改善/满意度。如13项研究中的12项所示，使用撑开皮瓣似乎能改善呼吸功能。此外，评估初次鼻整形术美学方面的研究表明，撑开皮瓣可以提供令人满意的结果。在大多数涉及该主题的研究中，撑开皮瓣与撑开移植物在呼吸功能改善和美学改善/满意度方面的比较结果相似。
本研究是第一项评估撑开皮瓣在初次鼻整形术中功能和美学效果的系统评价，其结果令人鼓舞，与撑开移植物相当。
