Nasal valve reconstruction: experience in 53 consecutive patients.
Nasal valve reconstruction: experience in 53 consecutive patients.
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DOI：
10.1001/archfaci.6.3.167
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发表时间：
2004-05-01
影响因子：
--
通讯作者：
Pearlman, Steven J
中科院分区：
文献类型：
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作者：
Khosh, Maurice M;Jen, Albert;Pearlman, Steven J
目的：探讨鼻瓣膜重建术中鼻瓣膜阻塞的原因，评价外科技术的有效性，评价鼻瓣膜修复术的美容效果。方法：回顾分析8年来53例鼻瓣膜成形术患者的临床资料。回顾了术前症状的严重程度、鼻瓣膜阻塞的原因、术前照片、手术时的解剖表现和重建技术。结果：鼻瓣膜阻塞最常见的原因是鼻成形术(79%)，其次是鼻外伤(15%)和先天性畸形(6%)。42例(79%)患者使用扩张器移植物，19例(36%)患者使用翼板移植物。患者接受至少1年的随访。12例瓣膜外功能不全患者术后均有改善。14例伴有内外瓣膜功能障碍的患者中，13例(93%)治疗后鼻塞改善。在27例内鼻瓣功能障碍患者中，24例(89%)报告鼻塞改善。扩张器移植导致了鼻子中三分之一的加宽。鼻翼瓣移植后鼻翼深层皱纹消失，鼻尖增宽。结论：我们发现手术矫正鼻瓣膜阻塞在改善主观鼻塞方面是非常有效的。正确的诊断和恰当的外科技术是这一手术成功的关键。
OBJECTIVES: To determine the cause of nasal valve obstruction in a series of patients requiring surgical correction, to evaluate the efficacy of our surgical techniques, and to assess the cosmetic effect of nasal valve repair.METHODS: Retrospective review of 53 consecutive cases involving adult patients who underwent nasal valve reconstruction over an 8-year period. The preoperative symptom severity, cause of nasal valve obstruction, preoperative photographs, anatomical findings at the time of surgery, and reconstructive techniques were reviewed. Postoperative photographs and resolution of symptoms were analyzed.RESULTS: The most common cause of nasal valve obstruction was previous rhinoplasty (79%), followed by nasal trauma (15%) and congenital anomaly (6%). Spreader grafts were used in 42 patients (79%), and alar batten grafts were used in 19 patients (36%). The patients received a minimum of 1 year of follow-up. All 12 patients with external valve dysfunction showed improvement after surgery. Thirteen (93%) of the 14 patients with concomitant external and internal valve dysfunction had improvement in nasal obstruction after treatment. Twenty-four (89%) of 27 patients with internal nasal valve dysfunction reported improvement in nasal obstruction. Spreader grafts caused a widening of the middle third of the nose. Alar batten grafts resulted in effacement of deep alar creases and a widening of the nasal tip.CONCLUSIONS: We have found that surgical correction of nasal valve obstruction is extremely effective in improving subjective nasal obstruction. Success of this procedure is predicated by correct diagnosis and appropriate surgical technique.