Carls F, Bier U, Jackson I T
Universitätsspital Zürich.
Mund Kiefer Gesichtschir. 1997 May;1 Suppl 1:S80-2.
There are various methods of lengthening the nose after trauma or for congenitally short noses. Forehead flaps and bone and cartilage grafts to the nasal dorsum are routinely performed. Bone grafts to the dorsum are onlay grafts that can show resorption. In craniofacial procedures, e.g., after Le Fort II/III osteotomies, the nose is brought forward and downward as necessary. This principle for nasal lengthening has been applied to 11 patients with congenitally short noses or after trauma. A coronal incision was made, an extensive subperiosteal skin undermining above the entire nasal bones and the piriform aperture was performed. Then a naso-frontal osteotomy was carried out, which runs downward to the piriform aperture. It runs either anteriorly to the lacrimal sac or it runs behind it through the medial orbital wall. It then crosses the inferior orbital rim and runs from there into the nasal floor. The nasal lining is released and the osteotomized fragment mobilized and moved caudally and anteriorly. This results in a deviation of the nasal septum, requiring a septoplasty. Cranial bone grafts (outer table) are interposed in the osteotomy gaps and fixed with microplates. This method of nose lengthening was applied to 11 patients with good results.
对于外伤后或先天性短鼻，有多种延长鼻子的方法。前额皮瓣以及鼻背的骨和软骨移植是常规操作。鼻背的骨移植是覆盖移植，可能会出现吸收。在颅面手术中，例如在Le Fort II/III截骨术后，根据需要将鼻子向前和向下移动。这种鼻子延长的原则已应用于11例先天性短鼻或外伤后的患者。做冠状切口，在整个鼻骨上方和梨状孔进行广泛的骨膜下皮肤剥离。然后进行鼻额截骨术，向下延伸至梨状孔。它要么在泪囊前方走行，要么通过眶内侧壁在泪囊后方走行。然后穿过眶下缘并从那里延伸至鼻底。松解鼻黏膜，将截骨后的骨块游离并向尾侧和前方移动。这会导致鼻中隔偏曲，需要进行鼻中隔成形术。将颅骨移植片（外板）插入截骨间隙并用微型钢板固定。这种鼻子延长方法应用于11例患者，效果良好。
