From the Dallas Plastic Surgery Institute; and the Division of Plastic, Maxillofacial, and Oral Surgery; Duke Children's Hospital.
Plast Reconstr Surg. 2022 Aug 1;150(2):439e-454e. doi: 10.1097/PRS.0000000000009290. Epub 2022 Jul 27.
After studying this article, the participant should be able to: (1) understand the functional significance of nasal anatomy as it relates to rhinoplasty and perform a comprehensive functional nasal assessment. (2) Identify the anatomical level of obstruction based on the authors' algorithmic approach and understand the current evidence supporting operative techniques for correcting nasal airway obstruction from septal deformity, inferior turbinate hypertrophy, internal nasal valve collapse, external nasal valve collapse. (3) Understand the current evidence supporting operative techniques for correcting nasal airway obstruction from septal deformity, inferior turbinate hypertrophy, internal nasal valve collapse, and external nasal valve collapse. (4) Appreciate the objective assessment tools for functional nasal surgery from a clinical and research perspective.
The intent of functional rhinoplasty is to improve nasal airflow (and the perception thereof) by surgically correcting the anatomical sources of obstruction in the nasal airway. Cosmetic and functional rhinoplasty are not mutually exclusive entities, and the techniques that address one area, inevitably may affect the another. The rate of functional problems after cosmetic rhinoplasty range from 15 to 68 percent with nasal airway obstruction found to be the most common indication for secondary surgery. The objective of this CME article is to provide readers with an understanding of the (1) functional components of nasal anatomy, (2) clinical functional assessment, and (3) the current evidence supporting corrective maneuvers for each component.
学习本文后，学员应能够：（1）了解与鼻整形术相关的鼻腔解剖结构的功能意义，并进行全面的功能性鼻腔评估。（2）根据作者的算法确定阻塞的解剖学水平，并了解支持纠正鼻中隔偏曲、下鼻甲肥大、鼻内瓣膜塌陷和鼻外瓣膜塌陷导致的鼻气道阻塞的手术技术的现有证据。（3）了解支持纠正鼻中隔偏曲、下鼻甲肥大、鼻内瓣膜塌陷和鼻外瓣膜塌陷导致的鼻气道阻塞的手术技术的现有证据。（4）从临床和研究的角度欣赏功能性鼻手术的客观评估工具。
功能性鼻整形术的目的是通过手术纠正鼻气道中阻塞的解剖学来源来改善鼻气流（和对其的感知）。美容和功能性鼻整形术并非相互排斥的实体，解决一个区域的技术不可避免地会影响另一个区域。美容性鼻整形术后出现功能性问题的发生率为 15%至 68%，其中鼻气道阻塞是二次手术最常见的指征。本文的目的是为读者提供对以下内容的理解：（1）鼻腔解剖结构的功能成分，（2）临床功能评估，（3）支持每个成分矫正手术的现有证据。
