闭合式鼻整形术中不同截骨方法效率的对比分析

Oleksandr O. Karchynskyi, A. V. Lupyr, Tetiana O. Karchynska
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摘要

目的是通过改进鼻部整形手术的现有方法和开发新方法,提高对鼻部骨骼原发性畸形且鼻呼吸功能明显受损的患者的治疗效果。 材料和方法38 名患者参与了研究。他们被分为两组,每组 19 人。两组患者的性别和年龄分布大致相同。对照组采用传统截骨术进行鼻整形手术。鼻内侧连续截骨术使用 4 毫米凿子进行。研究组在鼻整形术中结合使用了压电手术和经皮联合入路。同时,使用 3 毫米凿子进行外侧和横向侧截骨,使用压电刀切除驼峰、内侧和横向背截骨。两组的所有患者都只接受了封闭式的初级鼻整形术。 结果对两组患者的术后症状和并发症进行了研究:粘膜穿孔、鼻腔气道狭窄、骨不规则、眼睑肿胀、眶周瘀斑以及患者的总体满意度。对术后第一天、术后三天和治疗后一周的症状进行了评估。比较所得数据发现,使用压电手术结合经皮入路进行鼻整形术时,术中和术后并发症明显减少。此外,与传统截骨术相比,压电截骨术结合经皮入路具有许多优势,包括减少创伤并发症、在手术过程中获得更稳定的骨结构,从而获得更好的鼻整形预测结果,并因此获得更高的患者满意度。 结论将压钳截骨术与经皮入路相结合,可改善患者的术后状况,减少并发症,从而获得更好的鼻整形效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
COMPARATIVE ANALYSIS OF THE EFFICIENCY OF DIFFERENT METHODS OF OSTEOTOMY WHEN PERFORMING CLOSED RHINOPLASTY
The aim. Increasing the effectiveness of treatment of patients with primary deformity of the nasal skeleton with a pronounced violation of the function of nasal breathing, by improving existing and developing new methods of reconstructive surgery of the nose. Materials and methods. 38 patients participated in the study. They were divided into two groups of 19 patients each. The gender and age distribution in both groups was approximately the same. The control group had rhinoplasty performed using a traditional osteotomy. Endonasal continuous osteotomy was performed using a 4 mm chisel. The research group underwent a combination of piezoelectric surgery and combined transcutaneous access, during rhinoplasty. At the same time, a 3 mm chisel was used for lateral and transverse lateral osteotomies, and a piezotome was used to remove the hump, medial and transverse dorsal osteotomies. All patients of both groups underwent only primary rhinoplasty in a closed manner. Results. Postoperative symptoms and complications were studied in both groups: perforation of the mucous membrane, narrowing of the nasal airways, bony irregularities, eyelid swelling, periorbital ecchymoses, as well as overall patient satisfaction. Symptoms were evaluated on the first day after surgery, 3 days after surgery, and 1 week after treatment. When comparing the obtained data, a statistically significant decrease in intra- and post-operative complications was found when performing rhinoplasty using piezoelectric surgery in combination with transcutaneous access. Also, piezotome osteotomy in combination with transcutaneous access has a number of advantages over classic osteotomy, which consist in reducing traumatic complications, obtaining more stable bone structures during surgery, which gives a better predicted result of rhinoplasty, and therefore, greater patient satisfaction. Conclusions. Performing a combination of piezotome osteotomy with a transcutaneous approach improves the postoperative period for patients and contributes to a better rhinoplasty result due to fewer complications.
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