Jadczak Marcin, Krzywdzińska Sandra, Rozbicki Paweł, Jurkiewicz Dariusz
Department of Otolaryngology with Division of Cranio-Maxillo-Facial Surgery, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland.
J Clin Med. 2024 Dec 27;14(1):87. doi: 10.3390/jcm14010087.
A crooked nose is a challenge for a surgeon performing rhinoplasty. When performed correctly, rhinoseptoplasty aligns the nasal framework, restores nasal patency, and achieves facial symmetry. The key to this procedure is to dissect all the structures of the nasal framework, mobilize, reposition, and stabilize them. This study aims to discuss the quality of life after the rhinoseptoplasty and principles of treating a post-traumatic crooked nose with a view to improving the predictability and reliability of rhinoplasty procedures involving this challenging problem. The study compared the results of the Rhinoplasty Outcome Evaluation (ROE) and the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) through statistical analysis. Considering the structural deformities that lead to a crooked nose, the open approach seems to be preferred during a rhinoseptoplasty of a post-traumatic, crooked nose. When reconstructing the nasal septum, it is always necessary to leave the required amount of cartilage to provide nasal support and to secure the septum to the nasal spine. Osteotomies are important for fixing a crooked nose. The preoperative values for ROE were significantly lower before surgery than after surgery (8.7 vs. 20.2), while for SCHNOS, the postoperative values were statistically significantly lower compared to the preoperative values (46.0 vs. 9.1). Properly planned and performed surgery improves the functional and aesthetic outcomes in patients after rhinoseptoplasty.
对于进行隆鼻手术的外科医生来说，歪鼻是一项挑战。鼻中隔隆鼻术操作正确时，可使鼻支架结构对齐，恢复鼻腔通畅，并实现面部对称。该手术的关键在于解剖鼻支架的所有结构，使其活动、重新定位并稳定下来。本研究旨在探讨鼻中隔隆鼻术后的生活质量以及治疗创伤后歪鼻的原则，以期提高涉及这一具有挑战性问题的隆鼻手术的可预测性和可靠性。该研究通过统计分析比较了隆鼻结果评估（ROE）和标准化美容与健康鼻腔结果调查（SCHNOS）的结果。考虑到导致歪鼻的结构畸形，在创伤后歪鼻的鼻中隔隆鼻术中，开放式入路似乎更受青睐。重建鼻中隔时，始终需要保留所需量的软骨以提供鼻支撑，并将鼻中隔固定于鼻棘。截骨术对于矫正歪鼻很重要。ROE的术前值在手术前显著低于术后（8.7对20.2），而对于SCHNOS，术后值与术前值相比在统计学上显著降低（46.0对9.1）。精心规划和实施的手术可改善鼻中隔隆鼻术后患者的功能和美学效果。
