Division of Plastic Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA.
Department of Plastic Surgery, Loma Linda University School of Medicine, Loma Linda, CA, USA.
Cleft Palate Craniofac J. 2024 Dec;61(12):1941-1950. doi: 10.1177/10556656231190703. Epub 2023 Jul 28.
To evaluate the role of postoperative nasal stenting in preserving nasal shape and preventing nostril stenosis in cleft rhinoplasty, and to develop a classification system for postoperative nasal stents.
Systematic review.
Electronic and manual searches of scientific literature were conducted from 3 databases (PubMed, SCOPUS, OVID). Primary evidence that described postoperative nasal stenting in cleft rhinoplasty were included. Exclusion criteria included secondary evidence, non-English articles, and studies focusing on preoperative nasal stents.
Patients with cleft lip/nose of any type were included.
MAIN OUTCOME MEASURE(S): Role in preservation of nasal shape & symmetry, role in prevention of nostril stenosis, complications with the use of postoperative nasal stent.
Of the 13 articles, 9 papers described the preservation of nasal shape with nasal stents and three studies with a control group showed improved symmetry score. No studies evaluated the prevention of nostril stenosis; however, 2 studies reported improvement of nostril stenosis in secondary cleft rhinoplasty. The results of the included studies had significant heterogeneity. Nasal stents were classified into five types: Type I-spare parts assembled, Type II-prefabricated commercial, Type IIIa-patient specific 3D-printed static, Type IIIb-patient specific dynamic, and Type IV-internal absorbable. Total complications were 6.0%, including irritation (0.9%), infection (0.3%), and stent loss (4.6%).
Despite the lack of consensus with postoperative nasal stents, this review suggests its safety and role in preserving shape and improving stenosis. Our classification system highlights variability and the need for better quality studies to determine the efficacy of nasal stents.
评估术后鼻腔支架在保持鼻整形术后鼻形和预防鼻孔狭窄中的作用，并制定术后鼻腔支架分类系统。
系统评价。
从 3 个数据库（PubMed、SCOPUS、OVID）中进行电子和手动搜索科学文献。纳入描述腭裂鼻整形术后鼻腔支架的原始证据。排除标准包括次要证据、非英语文章以及关注术前鼻腔支架的研究。
纳入任何类型唇裂/鼻裂的患者。
在保持鼻形和对称性方面的作用、预防鼻孔狭窄方面的作用、使用术后鼻腔支架的并发症。
在 13 篇文章中，有 9 篇描述了鼻腔支架在保持鼻形方面的作用，3 项有对照组的研究显示对称性评分有所提高。没有研究评估预防鼻孔狭窄的作用；然而，2 项研究报告在二次腭裂鼻整形术中改善了鼻孔狭窄。纳入研究的结果存在显著异质性。鼻腔支架分为 5 种类型：I 型-组装备用件、II 型-预制商业、IIIa 型-患者特异性 3D 打印静态、IIIb 型-患者特异性动态和 IV 型-可吸收内支架。总并发症发生率为 6.0%，包括刺激（0.9%）、感染（0.3%）和支架丢失（4.6%）。
尽管对术后鼻腔支架缺乏共识，但本综述表明其具有安全性，在保持形状和改善狭窄方面具有作用。我们的分类系统突出了变异性，需要更好质量的研究来确定鼻腔支架的疗效。
