Di Giuli Riccardo, Mafi Pouya, Belloni Laura M, Vaccari Stefano, Klinger Francesco, Roxo Carlos W
From the Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Reconstructive and Aesthetic Plastic Surgery School, Humanitas Clinical and Research Hospital, University of Milan, Rozzano, Milan, Italy.
School of Specialization in Plastic, Reconstructive and Aesthetic Surgery, Milan University, Milan, Italy.
Plast Reconstr Surg Glob Open. 2024 Oct 16;12(10):e6272. doi: 10.1097/GOX.0000000000006272. eCollection 2024 Oct.
Septal extension grafts allow the precise elongation of the nasal septum to attain facial harmony and optimize aesthetic outcomes. In this context, septal surgery requires meticulous design to address both functional and aesthetic goals. Traditional septoplasty techniques often overlook aesthetic considerations and postoperative nasal structural stability, resulting in unresolved or recurrent deviations, nose tip drooping, and obstruction recurrences. Despite advancements in surgical techniques, achieving simultaneous septal alignment and long-term stability remains a significant challenge.
This study introduces a systematic 4-step technique. The procedure encompasses caudal septum liberation, placement of the septum extension cartilage graft, positioning of an ethmoidal bone graft, and redefinition through an intermediate cartilage.
A retrospective analysis of outcomes involving 753 patients was conducted with a minimum follow-up of 6 months. During follow-up visits, 1.73% of cases exhibited residual columellar asymmetry, and 0.66% showed tip asymmetries. The infection rate was 0.40%, with no cases of tip drop identified. The overall satisfaction rating on the Rhinoplasty Outcomes Evaluation questionnaire at 12 months postoperative was 9.3.
The technique provides a systematic approach to integrate functional and aesthetic objectives, emphasizing septal stability and alignment while concurrently addressing tip projection and stability. The study provides comprehensive insights into the principles, methodology, and advantages of this rhinoplasty technique. The outcomes underscore the efficacy of the technique, presenting a reliable and long-term stable solution.
鼻中隔延长移植可精确延长鼻中隔，以实现面部和谐并优化美学效果。在此背景下，鼻中隔手术需要精心设计，以兼顾功能和美学目标。传统的鼻中隔成形术技术往往忽视美学考量和术后鼻结构稳定性，导致鼻中隔偏曲未得到解决或复发、鼻尖下垂以及鼻塞复发。尽管手术技术有所进步，但实现鼻中隔同时对齐和长期稳定性仍然是一项重大挑战。
本研究介绍了一种系统的四步技术。该手术包括鼻中隔尾侧松解、鼻中隔延长软骨移植的放置、筛骨移植的定位以及通过中间软骨进行重新塑形。
对753例患者的手术结果进行了回顾性分析，随访时间最短为6个月。在随访期间，1.73%的病例出现残留的鼻小柱不对称，0.66%的病例出现鼻尖不对称。感染率为0.40%，未发现鼻尖下垂病例。术后12个月时，隆鼻效果评估问卷的总体满意度评分为9.3。
该技术提供了一种系统的方法来整合功能和美学目标，强调鼻中隔的稳定性和对齐，同时解决鼻尖突出和稳定性问题。该研究全面深入地探讨了这种隆鼻技术的原理、方法和优势。结果强调了该技术的有效性，提供了一种可靠且长期稳定的解决方案。
