Rohrich R J, Hollier L H
Division of Plastic Surgery, University of Texas Southwestern Medical School, Dallas, USA.
Clin Plast Surg. 1996 Apr;23(2):255-62.
The challenge for the modern rhinoplasty surgeon is to create a nose that appears natural and balances with the individual's face and ethnicity. The use of spreader grafts in endonasal rhinoplasty as described by Sheen has been expanded by the external approach to (1) straighten and buttress weakened L-struts in a high dorsally deviated septum, (2) recreate dorsal aesthetic lines, (3) reconstruct a narrow middle vault, and (4) restore the internal nasal valve. The advantages of the external approach in the use of septal spreader grafts includes ease of harvest, accurate contouring, and precise placement and suture stabilization to minimize postoperative graft displacement. The versatility of this technique allows the surgeon to attain consistent functional and aesthetic results in the management of dorsal mid-vault problems in primary and secondary rhinoplasty.
现代鼻整形外科医生面临的挑战是打造一个看起来自然且与个人面部和种族相协调的鼻子。如希恩所描述的，鼻内入路鼻整形术中使用撑开移植物，通过外部入路得到了扩展，用于：（1）矫正和支撑高位鼻中隔偏曲中薄弱的L形支柱；（2）重塑鼻背美学线；（3）重建狭窄的鼻中段；（4）修复鼻内瓣膜。外部入路在使用鼻中隔撑开移植物方面的优点包括易于获取、精确塑形、精准放置和缝合固定，以尽量减少术后移植物移位。该技术的多功能性使外科医生在初次和二次鼻整形术中处理鼻背中段问题时能够获得一致的功能和美学效果。
