Kwon Kyung Won
From the Department of Otolaryngology, Samsung Changwon Hospital, University of Sungkyunkwan, College of Medicine.
Plast Reconstr Surg. 2025 May 1;155(5):863e-866e. doi: 10.1097/PRS.0000000000011678. Epub 2024 Aug 14.
In recent years, the perpendicular plate of ethmoid (PPE) has become a prominent choice for bone-grafting materials. This study introduces the PPE split technique for efficient removal of the bony septum or the harvesting of partial PPE for septal batten grafts in rhinoplasty and septoplasty, particularly suited for cases with a thick PPE. In this study, this technique was used to minimize septal defects and prevent complications while achieving harvested bony grafts of the desired effective thickness. In this retrospective study, 36 patients underwent surgery using the PPE split technique (22 septoplasties and 14 rhinoplasties). The procedure involved detaching the PPE from the septal cartilage and performing a vertical plane osteotomy with a no. 10 scalpel blade to remove bony spurs or prepare batten grafts. Paranasal sinus computed tomography revealed that the average anteroinferior PPE thickness was 3.46 mm. This technique was used for bony batten graft harvesting (26 cases), bony spur removal, and septum reshaping (10 cases). Successful PPE harvesting was achieved in all cases except for 3, which experienced graft breakage. This study demonstrates the viability and effectiveness of the PPE split technique as a supplementary maneuver in septoplasty and rhinoplasty procedures. Its diverse applications include reshaping, correcting deviated septum, harvesting bony batten grafts, and providing support for an aesthetically pleasing nasal profile.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
近年来，筛骨垂直板（PPE）已成为骨移植材料的一个突出选择。本研究介绍了PPE劈开技术，用于在鼻整形术和鼻中隔成形术中有效去除骨性鼻中隔或获取部分PPE用于鼻中隔支撑移植物，特别适用于PPE较厚的病例。在本研究中，该技术用于尽量减少鼻中隔缺损并预防并发症，同时获得所需有效厚度的骨移植物。在这项回顾性研究中，36例患者接受了使用PPE劈开技术的手术（22例鼻中隔成形术和14例鼻整形术）。该手术包括将PPE与鼻中隔软骨分离，并用10号手术刀刀片进行垂直平面截骨术以去除骨棘或制备支撑移植物。鼻窦计算机断层扫描显示，PPE的平均前下厚度为3.46毫米。该技术用于获取骨支撑移植物（26例）、去除骨棘和重塑鼻中隔（10例）。除3例移植物断裂外，所有病例均成功获取PPE。本研究证明了PPE劈开技术作为鼻中隔成形术和鼻整形术辅助操作的可行性和有效性。其多种应用包括重塑、矫正鼻中隔偏曲、获取骨支撑移植物以及为美观的鼻外形提供支撑。
临床问题/证据水平：治疗性，IV级。
