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韦伯斯特三角的保留真的重要吗？下鼻甲头部低到低截骨术的回顾性分析。

Does the Webster's Triangle Preservation Really Matter? A Retrospective Analysis of the Low-to-Low Osteotomies in the Head of the Inferior Turbinates.

作者信息

Ishida Luis C, Guedes Matheus, Alves Guilherme F F, da Fonseca Julia O, Fonesca Eduardo L, Takahashi Giulia G, Gemperli Rolf

出版信息

Aesthet Surg J Open Forum. 2024 Sep 20;6:ojae079. doi: 10.1093/asjof/ojae079. eCollection 2024.

DOI:10.1093/asjof/ojae079
PMID:39497902
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11532800/
Abstract

BACKGROUND

Osteotomies are important maneuvers in the plastic surgeon's arsenal for the nasal dorsum treatment. However, there is a concern regarding a possible medialization of the inferior turbinate's heads and narrowing of the internal nasal valve if the Webster's triangle is not preserved.

OBJECTIVES

To analyze the mobilization of the inferior turbinates during primary rhinoplasty after lateral osteotomies.

METHODS

This is a retrospective study in which we analyzed 37 patients who underwent very low-to-low osteotomies in our service, during primary rhinoplasties. Axial and coronal computed tomography scans were obtained, and preoperative and 6 months postoperative images were compared with Radiant DICOM Viewer software (Medixant, Poznan, Poland) in 3-dimensional multiplanar reconstruction.

RESULTS

There were no statistically significant differences between preoperative and postoperative measurements of the lower turbinate's osseous bases, both in axial ( = .305) and coronal ( = .08) images.

CONCLUSIONS

Low-to-low osteotomies showed no medialization of the inferior turbinate's heads or narrowing of the internal nasal valve in this study.

摘要

背景

截骨术是整形外科医生用于鼻背治疗的重要手段。然而，如果不保留韦伯斯特三角，人们担心下鼻甲头部可能会向内侧移位以及鼻内阀变窄。

目的

分析初次鼻整形术中外侧截骨术后下鼻甲的活动情况。

方法

这是一项回顾性研究，我们分析了37例在我们科室接受初次鼻整形术时进行极低至低截骨术的患者。获取了轴向和冠状位计算机断层扫描图像，并使用Radiant DICOM Viewer软件（Medixant，波兰波兹南）在三维多平面重建中比较术前和术后6个月的图像。

结果

在轴向（P = 0.305）和冠状位（P = 0.08）图像中，下鼻甲骨基底部的术前和术后测量值之间均无统计学显著差异。

结论

在本研究中，极低至低截骨术未显示下鼻甲头部向内侧移位或鼻内阀变窄。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3452/11532800/d16a21909edc/ojae079f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3452/11532800/f8b06dd64afe/ojae079f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3452/11532800/97e8ce07f399/ojae079f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3452/11532800/ae75273ca18a/ojae079f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3452/11532800/2d27a4ba1822/ojae079f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3452/11532800/75320f291890/ojae079f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3452/11532800/d16a21909edc/ojae079f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3452/11532800/f8b06dd64afe/ojae079f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3452/11532800/97e8ce07f399/ojae079f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3452/11532800/ae75273ca18a/ojae079f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3452/11532800/2d27a4ba1822/ojae079f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3452/11532800/75320f291890/ojae079f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3452/11532800/d16a21909edc/ojae079f6.jpg

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本文引用的文献

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Understanding Why Lateral Osteotomy During Rhinoplasty Can Be Performed Safely.了解鼻整形术中为何能安全地进行外侧截骨术。
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Rhinoplasty.隆鼻术
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Superior rhinoplasty outcomes with precise nasal osteotomy: an individualized approach for maintaining function and achieving aesthetic goals.精确鼻骨切开术实现卓越隆鼻效果：一种维持功能并达成美学目标的个体化方法。
Aesthet Surg J. 2015 Jan;35(1):28-39. doi: 10.1093/asj/sju013.
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Osteotomies in rhinoplasty surgery.鼻整形手术中的截骨术。
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Clinical consensus statement: Diagnosis and management of nasal valve compromise.临床共识声明：鼻瓣膜功能不全的诊断与管理
Otolaryngol Head Neck Surg. 2010 Jul;143(1):48-59. doi: 10.1016/j.otohns.2010.04.019.
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