Yadav Rajshri, Masrat Heena, Wani Fozia, Khan Nazir A
Otorhinolaryngology, Umanath Singh Autonomous State Medical College, Jaunpur, IND.
Otorhinolaryngology, Urban Primary Health Centre, Srinagar, IND.
Cureus. 2025 Jul 20;17(7):e88396. doi: 10.7759/cureus.88396. eCollection 2025 Jul.
Introduction Rhinoplasty is one of the most intricate procedures in facial plastic surgery, requiring a balance between functional restoration and aesthetic refinement. The existing literature often emphasizes comparisons between surgical techniques; however, there is a lack of studies that systematically evaluate deformity distribution across nasal regions and correlate these findings with corrective strategies. This study aims to analyze the anatomical patterns of nasal deformities in primary rhinoplasty patients, and document the region-specific surgical interventions employed. Methods This prospective clinical observational study was conducted at the Department of Otorhinolaryngology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India, from August 2013 to December 2015. Thirty patients (n = 17 males and n = 13 females) with primary external nasal deformities were included. Each patient was evaluated for anatomical involvement - upper two-thirds, lower one-third, or both - and intraoperative corrective techniques, including the use and type of autologous grafts, were recorded. Results Out of the total 30 patients, 14 subjects (46.67%) had deformities involving both the upper two-thirds and lower one-third of the nose, 10 (33.33%) had isolated lower one-third deformities, and six (20.00%) had upper two-thirds involvement only. The most frequent deformity was dorsal hump (n = 24 patients, 80.00%), followed by dorsal deviation (n = 18 patients, 60.00%), reduced columellar support (n = 10 patients, 41.67%), and caudal septal deviation (n = 5 patients, 20.83%). Autologous cartilage grafts were used in 15 patients (50.00%), with septal cartilage used in 13 (86.67%), and conchal cartilage in two subjects (13.33%). Conclusion Region-based anatomical analysis is primary for planning primary rhinoplasty. Customized surgical correction, supported by targeted use of autologous grafts, improves structural integrity and enhances aesthetic outcomes.
引言
隆鼻术是面部整形手术中最复杂的手术之一，需要在功能恢复和美学改善之间取得平衡。现有文献常常强调手术技术之间的比较；然而，缺乏系统评估鼻各区域畸形分布并将这些发现与矫正策略相关联的研究。本研究旨在分析初次隆鼻患者鼻畸形的解剖模式，并记录所采用的区域特异性手术干预措施。
方法
本前瞻性临床观察性研究于2013年8月至2015年12月在印度斯利那加的谢里夫克什米尔医学科学研究所耳鼻喉科进行。纳入30例原发性鼻外畸形患者（n = 17例男性，n = 13例女性）。评估每位患者的解剖受累情况——鼻上三分之二、下三分之一或两者——并记录术中矫正技术，包括自体移植物的使用和类型。
结果
在总共30例患者中，14例受试者（46.67%）的畸形累及鼻上三分之二和下三分之一，10例（33.33%）有孤立的下三分之一畸形，6例（20.00%）仅累及鼻上三分之二。最常见的畸形是驼峰鼻（n = 24例患者，80.00%），其次是鼻梁偏斜（n = 18例患者，60.00%）、鼻小柱支撑不足（n = 10例患者，41.67%）和鼻中隔尾端偏斜（n = 5例患者，20.83%）。15例患者（50.00%）使用了自体软骨移植物，其中13例（86.67%）使用鼻中隔软骨，2例受试者（13.33%）使用耳甲软骨。
结论
基于区域的解剖分析是初次隆鼻手术规划的基础。在针对性使用自体移植物的支持下进行定制化手术矫正，可改善结构完整性并提高美学效果。
