From the Departments of Plastic Surgery.
private practice.
Plast Reconstr Surg. 2023 Sep 1;152(3):540-546. doi: 10.1097/PRS.0000000000010256. Epub 2023 Feb 1.
In the open rhinoplasty technique, the soft tissue and ligaments are vulnerable to injury. Reconstruction of the ligaments is not performed routinely. The authors aimed to assess the effect of preservation of the nasal ligaments (ie, scroll, septocolumellar, and Pitanguy ligaments) in open-approach rhinoplasty.
In this prospective cohort study, 32 patients underwent open rhinoplasty with ligament preservation after receiving precise training on five cadavers.
All patients had improved aesthetic and functional outcome in the early postoperative period with long-lasting preservation of tip projection and results. No patient needed secondary revision surgery for tip dropping or malrotation. The objective findings and subjective assessments were satisfying for the patients and surgeons.
Refinements of nasal surgery have no limits. This study suggests that nasal ligament reconstruction, including of the scroll, septocolumellar, and Pitanguy ligaments, could maintain nasal tip projection and rotation for a long time.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
在开放式鼻整形术中，软组织和韧带容易受伤。韧带的重建通常不进行。作者旨在评估保留鼻韧带（即卷突、鼻中隔-鼻翼和皮坦基韧带）在开放式鼻整形术中的效果。
在这项前瞻性队列研究中，32 名患者在接受了五具尸体上的精确培训后，接受了保留韧带的开放式鼻整形术。
所有患者在术后早期均获得了改善的美学和功能结果，鼻尖突出和效果持久保留。没有患者因鼻尖下垂或旋转不良而需要二次修复手术。患者和外科医生对客观发现和主观评估都感到满意。
鼻手术的精细化没有限制。本研究表明，包括卷突、鼻中隔-鼻翼和皮坦基韧带在内的鼻韧带重建可以长时间维持鼻尖突出和旋转。
临床问题/证据水平：治疗，IV。
