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歪鼻畸形单手术与联合手术功能及美学效果的比较。

Comparison on functional and esthetic outcomes between single and combined surgery to crooked nose deformities.

作者信息

Kwon Soo Ha, Lee Ta-Jen, Hsiao Yen-Chang, Huang Chien-Chia, Fu Chia-Hsiang, Yen Cheng-I

机构信息

Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taoyuan, Taiwan.

Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.

出版信息

J Plast Reconstr Aesthet Surg. 2025 Feb;101:1-6. doi: 10.1016/j.bjps.2024.11.026. Epub 2024 Nov 25.

Abstract

BACKGROUND

Nose deviation deformities pose a complex cosmetic and functional problem. The most common surgical intervention to manage such deformities is septorhinoplasty, typically performed by a plastic surgeon or a rhinologist. This study investigated the effect of a combined operation by a plastic surgeon and rhinologist, comparing them with those operations performed singlehandedly by a plastic surgeon.

METHODS

From January 2017 to January 2022, 99 patients with deviated noses were treated. Fifty-nine underwent the combined operation, whereas 40 underwent surgery performed by a plastic surgeon. In the combined operation group, the rhinologist performed endonasal septoplasty and turbinoplasty, while the plastic surgeon performed open rhinoplasty, osteotomies, caudal septal deviation correction, camouflage procedure, esthetic enhancement, and dorsal augmentation. Subsequently, the rhinologist checked the airway and applied a nasal tamponade. Treatment outcomes were evaluated using the Rhinoplasty Health Inventory and Nasal Outcomes (RHINO) questionnaire and incidence of postoperative complications.

RESULTS

Of the 79 patients who responded to the RHINO questionnaire, 33 underwent an operation by a plastic surgeon, whereas 46 underwent the combined operation. All cases showed improved scores on the RHINO questionnaire postoperatively, with significantly higher scores in the combined group (p = 0.032). Furthermore, the combined group showed more significant improvements in function-related questions, despite longer total operation durations. The overall complication rate was 10.1%.

CONCLUSION

A combined surgical correction for deviated nose by a plastic surgeon and rhinologist could provide better subjective outcomes, especially in functional outcomes.

摘要

背景

鼻偏斜畸形带来了复杂的美容和功能问题。处理此类畸形最常见的外科手术是鼻中隔鼻成形术,通常由整形外科医生或鼻科医生进行。本研究调查了整形外科医生和鼻科医生联合手术的效果,并将其与整形外科医生单独进行的手术效果进行比较。

方法

2017年1月至2022年1月,对99例鼻偏斜患者进行了治疗。59例接受了联合手术,而40例接受了整形外科医生单独进行的手术。在联合手术组中,鼻科医生进行鼻内鼻中隔成形术和鼻甲成形术,而整形外科医生进行开放式鼻成形术、截骨术、鼻中隔尾端偏斜矫正、掩饰手术、美学改善和鼻背增高。随后,鼻科医生检查气道并进行鼻腔填塞。使用鼻成形术健康量表和鼻腔结果(RHINO)问卷以及术后并发症发生率评估治疗效果。

结果

在79例回复RHINO问卷的患者中,33例接受了整形外科医生的手术,而46例接受了联合手术。所有病例术后在RHINO问卷上的得分均有所提高,联合组得分显著更高(p = 0.032)。此外,尽管总手术时间更长,但联合组在功能相关问题上的改善更为显著。总体并发症发生率为10.1%。

结论

整形外科医生和鼻科医生联合进行鼻偏斜的手术矫正可以提供更好的主观效果,尤其是在功能效果方面。

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