Pontell J, Slavit D H, Kern E B
Department of Otolaryngology, SUNY-Health Science Center at Brooklyn, USA.
Ear Nose Throat J. 1998 Feb;77(2):106-8, 111-2.
Post-rhinoplasty nasal osbtruction is often related to narrowing in the region of the nasal valve. Correction of this obstruction can include inferior turbinectomy, septoplasty spreader grafts and nasal valvuloplasty. The authors have seen cases of severe valve stenosis related to infracture after osteotomy which did not respond to any of the aforementioned procedures. These patients were treated with revision osteotomy with outfracture. We discuss patient selection and surgical technique for revision osteotomy with outfracture as well as a cadaver dissection demonstrating the effects of infracture and outfracture on valve area. The clinical results, based on patient satisfaction and pre- and postoperative photographs, are presented. Revision osteotomy with outfracture should be included in the surgeon's armamentarium for the treatment of post-rhinoplasty nasal obstruction.
鼻整形术后鼻阻塞通常与鼻瓣膜区域狭窄有关。纠正这种阻塞的方法可包括下鼻甲切除术、鼻中隔成形术、撑开移植术和鼻瓣膜成形术。作者曾见过一些因截骨术后骨折导致严重瓣膜狭窄的病例，这些病例对上述任何一种手术均无反应。这些患者接受了外骨折的翻修截骨术治疗。我们讨论了外骨折翻修截骨术的患者选择和手术技术，以及一项尸体解剖，该解剖展示了内骨折和外骨折对瓣膜面积的影响。基于患者满意度以及术前和术后照片给出了临床结果。外骨折翻修截骨术应纳入外科医生治疗鼻整形术后鼻阻塞的手段之中。
