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首页> 外文期刊>Acta Otorhinolaryngologica Italica >Lateral osteotomy plus hump resection vs hump re-modeling without lateral osteotomy: impact on frontal nasal view
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Lateral osteotomy plus hump resection vs hump re-modeling without lateral osteotomy: impact on frontal nasal view

机译：外侧截骨加驼背切除术与无外侧截骨术的驼峰重塑：对额鼻观影的影响

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摘要

This article reviews the personal experience and evolution of osteotomy approach in the last years of practice to obtain a natural appearance of the nasal pyramid in the frontal view. The aim is to analyse the long-term results after rhinoplasty on nasal width in two different cohorts of patients subjected to lateral osteotomy plus hump resection vs. hump re-modeling without lateral osteotomy considering the impact on frontal nasal view and how this relates to changes observed over time in the nasal width and contour. The study was carried out between January 2010 and December 2013, considering 42 patients undergoing primary rhinoplasty. Comparisons were made between the change in the dorsal width of the nasal pyramid at the level of the medial canthi, at the level of the inferior margin of the orbital rim, of ventral width of the nasal pyramid at the level of the medial canthi and at the level of the inferior margin of the orbital rim. In the first group, we found significant postoperative mean widening of the intercanthal dorsal width and narrowing of the ventral, while in the second group there was significant postoperative mean narrowing of the dorsal width both at level of the medial canthi and the anterior junction of the nasal bones. Our analysis seems to point out that dorsal grafting is useful for re-shaping the nasal profile with a persistent and harmonious correction of the dorsal frontal dimension of the nose. Simple hump removal/repositioning may be considered in selected instances to avoid lateral osteotomies. It also seems of paramount importance to tailor osteotomies according to nasal bone anatomy: large, strong and curved bones deserve aggressive narrowing by lateral and medial continuous osteotomies without periosteal elevation, although this approach may be insufficient to narrow the upper dorsal aspect of the nose.
机译：本文回顾了近几年实践中的亲身经历和截骨术的演变，从而获得了正面观察时鼻金字塔的自然外观。目的是分析在接受侧截骨加驼背切除术与不进行侧截骨术的驼峰重塑的两个不同队列中，隆鼻成形术后鼻宽度的长期结果，考虑对额鼻视图的影响及其与变化的关系随时间推移观察到的鼻宽度和轮廓。该研究在2010年1月至2013年12月之间进行，研究对象为42例行鼻整形术的患者。比较了内角th水平，眶缘下缘水平，鼻角vent腹宽度在内can水平和鼻at水平时鼻锥背宽的变化。眼眶下缘的水平。在第一组中，我们发现术后的平均椎间孔背侧宽度变宽和腹侧变窄，而在第二组中，在内侧can体水平和前交叉点处，背侧宽度均明显变大。鼻骨。我们的分析似乎指出，背侧移植可通过持续，和谐地矫正鼻背的正面尺寸来重新塑形鼻廓。在选定的情况下，可以考虑简单的驼峰切除/重新定位以避免侧截骨术。根据鼻骨解剖结构调整截骨术似乎也极为重要：较大，结实和弯曲的骨骼应通过外侧和内侧连续截骨术而无骨膜抬高而进行积极的缩小，尽管这种方法可能不足以缩小鼻子的上背部。

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