Wang Shuyuan, Wang Xiancheng, Xiang Xingyu, Song Dandan, Xiao Muzhang, Yu Zidi, Sun Yang, Xiong Xiang, Meng Xianxi, Li Wenbo, Yi Zhongjie, Qiao Zhihua
Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, China.
Aesthetic Plast Surg. 2025 Mar;49(5):1246-1254. doi: 10.1007/s00266-024-04264-y. Epub 2024 Aug 23.
To investigate the application and therapeutic efficacy of a novel cartilage framework: the external septa framework in East Asian rhinoplasty.
From November 2021 to April 2023, Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital, Central South University, treated 41 patients with autologous costal cartilage rhinoplasty using an innovation external septal framework. The surgical open approach used an inverted V-shaped trans-columellar incision and marginal incision. The sixth or seventh costal cartilage was harvested to form the nasal columella support grafts (strut), external nasal septal graft, cap grafts, and shield grafts, in which the nasal column support graft and external nasal septal graft are connected in a way of tongue in groove to form a external septum framework to support and lengthen the tip. A cap graft is used to shape the tip of the nose, the rectus abdominis fascia is used to cover the tip of the nose, and the shield grafts are used to augment the inferior lobules. ePTFE was sculpted according to the degree of augment of the nasal dorsum and implanted on the dorsal to augment the nasal dorsum. Clinical outcomes were assessed through standard facial photographs taken during the preoperative and follow-up periods, and a postoperative satisfaction survey was completed with regular follow-up using the rhinoplasty outcome evaluation scale (ROE) and visual analogue scale (VAS). Results of objective and subjective measurements before and after surgery were compared utilizing paired-sample t tests. Values of P < 0.05 were considered significant. Nasal framework's objective evaluation outcomes were assessed by measuring the patients' preoperative and postoperative nasolabial angle, nasal length, and nasal tip projection. (The distance between the pronasale and the alar-cheek junction was calculated as the tip projection.) The comparison of preoperative and postoperative nasolabial angle and nasal length was performed using the paired-sample t test, and the comparison of nasal tip projection was performed using the Wilcoxon signed rank-sum test for the comparison of paired samples. Values of P < 0 .05 were considered significant.
A total of 41 patients were treated, including 9 males and 32 females, ranging in age from 17 to 48 years(32.8 ± 1.5 years old), In the study, an average follow-up period of 19.85 ± 4.88 months was observed (range 12-29 months). There was no long-term or short-term complication observed. The aesthetic outcome of all cases such as saddle nose, deviated nasal columella, bilateral asymmetry of the nose, bilateral nasal base depression, and bulbous tip was satisfactory. Patient satisfaction evaluation: The ROE scale was (11.85 ± 2.46) preoperatively and (17.43 ± 2.15) postoperatively. The VAS scores were (4.86 ± 1.60) preoperatively and (8.48 ± 1.25) postoperatively. The difference of ROE scale and VAS scores among the patients was statistically significant (P < 0. 05), and 88.9% of patients were satisfied following those procedures. In terms of nasolabial angle, preoperative and postoperative measurements of 41 patients were (86.11 ± 2.25)° and (98.66 ± 1.90)°, respectively, and the difference of nasolabial angle was statistically significant (P < 0.05); nasal length measurements were 39.43 ± 1.55 mm (37.95-43.51 mm) preoperatively and 42.17 ± 1.46 mm (40.23-45.62 mm) postoperatively; in terms of nasal tip projection, preoperative and postoperative measurements of median values were 1.84(1.73,2.01) cm and 2.15(2.02,2.32) cm, respectively; and the difference between preoperative and postoperative values was statistically significant (P < 0.05).
The innovative cartilage framework-external septal framework, avoids the dissection of septa and absorption of septal cartilage with compression of ESG, it is easy to be performed, and it is also stable and strong to achieve in good aesthetic result.
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探讨一种新型软骨支架——外鼻中隔支架在东亚鼻整形术中的应用及治疗效果。
2021年11月至2023年4月，中南大学湘雅二医院整形美容（烧伤）外科采用创新的外鼻中隔支架为41例患者行自体肋软骨鼻整形术。手术开放入路采用倒V形跨鼻小柱切口和边缘切口。取第六或第七肋软骨形成鼻小柱支撑移植物（支柱）、鼻外中隔移植物、帽状移植物和盾牌状移植物，其中鼻柱支撑移植物和鼻外中隔移植物采用榫槽连接方式形成外鼻中隔支架，以支撑和延长鼻尖。使用帽状移植物塑造鼻尖形状，使用腹直肌筋膜覆盖鼻尖，使用盾牌状移植物增大鼻小柱下部。根据鼻背增高程度雕刻ePTFE并植入鼻背以增高鼻背。通过术前和随访期间拍摄的标准面部照片评估临床结果，并在定期随访中使用鼻整形术结果评估量表（ROE）和视觉模拟量表（VAS）完成术后满意度调查。利用配对样本t检验比较手术前后客观和主观测量结果。P < 0.05的值被认为具有统计学意义。通过测量患者术前和术后的鼻唇角、鼻长和鼻尖突出度来评估鼻支架的客观评估结果。（鼻前点与鼻翼-面颊交界处之间的距离计算为鼻尖突出度。）术前和术后鼻唇角和鼻长的比较采用配对样本t检验，鼻尖突出度的比较采用配对样本Wilcoxon符号秩和检验。P < 0.05的值被认为具有统计学意义。
共治疗41例患者，其中男性9例，女性32例，年龄17至48岁（平均32.8 ± 1.5岁）。研究中观察到平均随访期为19.85 ± 4.88个月（范围12 - 29个月）。未观察到长期或短期并发症。所有病例如鞍鼻、鼻小柱偏斜、鼻双侧不对称、双侧鼻基底凹陷和球鼻尖等的美学效果均令人满意。患者满意度评价：ROE量表术前为（11.85 ± 2.46），术后为（17.43 ± 2.15）。VAS评分术前为（4.86 ± 1.60），术后为（8.48 ± 1.25）。患者之间ROE量表和VAS评分的差异具有统计学意义（P < 0.05），88.9%的患者对这些手术满意。在鼻唇角方面，41例患者术前和术后测量值分别为（86.11 ± 2.25）°和（98.66 ± 1.90）°，鼻唇角差异具有统计学意义（P < 0.05）；鼻长测量术前为39.43 ± 1.55 mm（37.95 - 43.51 mm），术后为42.17 ± 1.46 mm（40.23 - 45.
