Tarragona Ramon, Mirra Carlo
Plastic, Reconstructive and Aesthetic Surgery Department, Clinica Planas, Pere II de Montcada 16, Barcelona, 08034, Spain.
Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Bio-Medico University Hospital, Via Alvaro del Portillo 200, Rome, Italy.
Aesthetic Plast Surg. 2024 Nov 18. doi: 10.1007/s00266-024-04496-y.
Dorsal management is a challenging step in rhinosurgery. In the last decade, an old philosophy of preserving the dorsum has gained popularity alongside the traditional hump resection proposed by Joseph. This study aims to investigate the journey of a rhinosurgeon transitioning from structural to dorsal preservation techniques in primary rhinoplasty.
A retrospective study was conducted on 594 consecutive patients who underwent primary rhinoplasty by the main surgeon (R.T.) with at least 12 months of follow-up. All surgeries were categorized based on the dorsal approach into Structural Dorsal Rhinoplasty (SDR), Partial Dorsal Preservation Rhinoplasty (PDPR), and Total Dorsal Preservation Rhinoplasty (TDPR). The three groups were compared based on the following variables: operative time, long-term complication rate, and re-intervention rate.
The study included 67 males and 527 females, with an average age of 31.43 years. The average anesthesia operative times were 231.30 minutes for SDR, 241.74 minutes for PDP, and 230.32 minutes for TDP, with no statistically significant differences observed. The complication and revision rates were as follows: SDR had 12.74% complications and 7.32% revisions, PDPR had 13.37% complications and 3.82% revisions, and TDPR had 10.57% complications and 3.25% revisions. Hump recurrence rates were 2.54% in SDR, 7.64% in PDPR, and 6.50% in TDPR. Contour irregularities occurred in 9.55% of SDR, 5.09% of PDPR, and 2.44% of TDPR cases. Both hump recurrence and contour irregularities showed statistically significant differences among the three groups.
This study analyzed how the aforementioned variables change during the transition from structural to dorsal preservation techniques, considering the latter as the natural evolution in rhinoplasty.
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鼻背处理是鼻整形手术中具有挑战性的一步。在过去十年中，一种保留鼻背的古老理念在约瑟夫提出的传统驼峰切除术之外逐渐流行起来。本研究旨在调查一名鼻整形医生在初次鼻整形手术中从结构型技术向鼻背保留技术转变的过程。
对由主刀医生（R.T.）进行初次鼻整形手术且至少随访12个月的594例连续患者进行回顾性研究。所有手术根据鼻背入路分为结构型鼻背整形术（SDR）、部分鼻背保留整形术（PDPR）和完全鼻背保留整形术（TDPR）。基于以下变量对三组进行比较：手术时间、长期并发症发生率和再次干预率。
该研究纳入67例男性和527例女性，平均年龄31.43岁。SDR的平均麻醉手术时间为231.30分钟，PDP为241.74分钟，TDP为230.32分钟，未观察到统计学上的显著差异。并发症和修复率如下：SDR的并发症发生率为12.74%，修复率为7.32%；PDPR的并发症发生率为13.37%，修复率为3.82%；TDPR的并发症发生率为10.57%，修复率为3.25%。驼峰复发率在SDR中为2.54%，在PDPR中为7.64%，在TDPR中为6.50%。轮廓不规则在SDR病例中占9.55%，在PDPR中占5.09%，在TDPR中占2.44%。驼峰复发和轮廓不规则在三组之间均显示出统计学上的显著差异。
本研究分析了在从结构型技术向鼻背保留技术转变过程中上述变量是如何变化的，将后者视为鼻整形手术的自然演变。
证据等级IV：本期刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266 。
