Aldosari Badi F, Alhajress Rafeef I, Bogari Ahmad O
From the Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia.
Plast Reconstr Surg Glob Open. 2024 Sep 10;12(9):e6153. doi: 10.1097/GOX.0000000000006153. eCollection 2024 Sep.
Nasal hump reduction, a common procedure in rhinoplasty, aims to create a harmonious nasal appearance with smooth dorsal lines. An alternative to traditional osteotomes is the carbide-tip nasal rasp, effective in eliminating modest contour deformities. However, the broad movements and physical forces of manual rasping can significantly weaken the osseocartilaginous vault. Power-assisted instruments have been used to reduce soft tissue trauma. Although long-term clinical outcomes of power-assisted instrumentation are pending, initial reports have been positive.
This retrospective chart review encompassed 220 consecutive rhinoplasty cases conducted by the senior author, all involving women aged 19-37 years. Excluding 80 cases that did not involve bone reduction, the analysis concentrated on 140 patients who underwent bone reduction procedures. The success of nasal hump reduction was evaluated based on the joint satisfaction of both the patient and the surgeon with the surgical improvement.
The open rhinoplasty approach was predominantly used for surgical exposure to minimize inadvertent rasping of the nasal cartilage. Among the 140 patients undergoing power-assisted bone removal, all but five achieved an initially satisfactory refinement of the bony nasal contour. Notably, no serious complications were observed throughout the study. Unfortunately, one patient did not comply with the monthly steroid injections, leading to the necessity of revision surgery for the removal of regenerated bone.
The integration of power-assisted instrumentation in rhinoplasty procedures represents a promising advancement, addressing challenges associated with traditional methods.
鼻背驼峰修整术是鼻整形术中的常见操作，旨在打造鼻背线条流畅、外观和谐的鼻子。传统骨凿的替代工具是硬质合金头鼻锉，它能有效消除轻微的轮廓畸形。然而，手动锉磨的大幅度动作和物理力量会显著削弱鼻骨软骨复合体。电动辅助器械已被用于减少软组织创伤。尽管电动辅助器械的长期临床效果尚待确定，但初步报告结果良好。
这项回顾性病历审查涵盖了资深作者连续进行的220例鼻整形手术病例，所有病例均为19至37岁的女性。排除80例未涉及鼻骨切除的病例后，分析集中在140例行鼻骨切除手术的患者。鼻背驼峰修整术的成功与否是根据患者和外科医生对手术改善效果的共同满意度来评估的。
开放式鼻整形手术入路主要用于手术暴露，以尽量减少对鼻软骨的意外锉磨。在140例行电动辅助鼻骨切除的患者中，除5例患者外，其余患者的鼻骨轮廓初步修整效果均令人满意。值得注意的是，在整个研究过程中未观察到严重并发症。遗憾的是，有1例患者未按要求每月注射类固醇，导致需要进行修复手术以去除再生骨。
电动辅助器械应用于鼻整形手术是一项有前景的进展，解决了传统方法存在的问题。
