Retrospective study of different types of rhinoplasty frameworks
10.3760/cma.j.cn114453-20210517-00222
- VernacularTitle:不同类型支架鼻整形术的回顾性研究
- Author:
Yiwen DENG
1
;
Xiancheng WANG
;
Yang SUN
;
Kai YANG
;
Zhihua QIAO
;
Lewei JIN
;
Quanding YAN
;
Chunjie LI
;
Xiang XIONG
;
Xianxi MENG
;
Wenbo LI
Author Information
1. 中南大学湘雅二医院整形美容(烧伤)外科，长沙 410011
- Keywords:
Rhinoplasty;
Framework;
Classification;
Costal cartilage;
Ear cartilage;
Transplants
- From:
Chinese Journal of Plastic Surgery
2023;39(3):293-302
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the structural features, stability and postoperative effect of integrated framework, 1+ 1 framework, 2+ 1 framework, 4+ 1 framework, and Y-shaped nasal framework.Methods:A retrospective analysis was performed based on the clinical data of patients underwent in Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital, Central South University from February 2019 to November 2020. According to rhinoplasty framework, the patients were divided into integrated framework group, 1+ 1 framework group, 2+ 1 framework group, 4+ 1 framework group, and Y-shaped framework group. Based on the principle of plane photography, the stability of the nasal framework was evaluated by measuring the nasal tip projection and the nasolabial angle 1 month after surgery, and 12 months after surgery. The satisfaction of patients and the incidence of postoperative complications were collected. The difference in nasolabial angle and nasal tip projection data of postoperation 1 month and postoperative 12 months among each group were analyzed by one-way analysis vaniance or Kruskal-Waliis H test.Bonferroni test or Nemenyi test was used for pairwise comparison between groups. P< 0.05 was considered statistically significant. Results:A total of 201 patients (18 males and 183 females, aged 18-46 years, average aged 26.6±5.9 years)were included in this study and followed up for 12-21 months. There were 45 patients in the integrated framework group, 45 patients in the 1+ 1 framework group, 34 patients in the 2+ 1 framework group, 35 patients in the 4+ 1 framework group, and 42 patients in the Y-shaped framework group. Four patients with Y-shaped framework had significant nasal tip supination 12 months after surgery. Among the patients with 1+ 1 framework, 1 patient showed slight columella distortion 6 months after surgery, and 3 patients showed significant nasal tip subrotation 12 months after surgery. One patient in 2+ 1 framework group developed nasal infection 92 days after surgery. No complications were found in other groups during follow-up. In terms of nasal tip projection during postoperative follow-up, the median difference of nasal tip projection between 12 months and 1 month after surgery in 2+ 1 framework group, integrated framework group, 1+ 1 framework group, and 4+ 1 framework group, and Y-shaped framework group was -0.08 cm, -0.09 cm, -0.20 cm, -0.10 cm and -0.17 cm, respectively. The difference of nasal tip projection among the five groups was statistically significant ( P<0.01). The difference between 2+ 1 framework group and 1+ 1 framework group or Y-shaped framework group was statistically significant( P<0.05). The difference between 4+ 1 framework group and 1+ 1 framework group or Y-shaped framework group was statistically significant ( P<0.05). The difference between integrated nasal framework group and 1+ 1 framework group or Y-shaped framework group was statistically significant ( P<0.05). The difference between Y-shaped framework group and 1+ 1 framework group was statistically significant ( P<0.05). In terms of nasolabial angle during postoperative follow-up, the median difference of nasolabial angle between 12 months and 1 month after surgery in 2+ 1 framework group, integrated framework group, 1+ 1 framework group, and 4+ 1 framework group, and Y-shaped framework group was -4.20°, -3.80°, -6.50°, -4.10° and -6.35°, respectively. The difference of nasolabial angle among the five groups was statistically significant ( P<0.01). The difference between 2+ 1 framework group and 1+ 1 framework group or Y-shaped framework group was statistically significant( P<0.05). The difference between 4+ 1 framework group and 1+ 1 framework group or Y-shaped framework group was statistically significant ( P<0.05). The difference between integrated nasal framework group and 1+ 1 framework group or Y-shaped framework group was statistically significant ( P<0.05). Patient satisfaction evaluation, 2+ 1 framework group had the highest satisfaction(34/34, 100.00%), followed by 4+ 1 framework group (34/35, 97.14%), integrated framework group(42/45, 93.33%), Y-shaped framework group(36/42, 85.71%), 1+ 1 framework group(37/45, 82.22%). Conclusion:The changes of nasolabial angle and nasal tip projection in 2+ 1 framework, integrated framework, and 4+ 1 framework were smaller than those in Y-shaped framework and 1+ 1 framework.2+ 1 framework was convenient and had good postoperative stability and high patient satisfaction.
