RU2251979C1 - Method for correcting nasal bottom and wings - Google Patents

Abstract

FIELD: medicine, plastic and cosmetic surgery.

SUBSTANCE: one should dissect excessive skin of nasal wings with spindle-shaped incisions by not dissecting the mucosa. Then one should perform wide detachment of dermal layer of nasal wings against nasal cavitary mucosa. The method enables to decrease the number of postoperational complications and obtain stable cosmetic result in remote period after operation conducted.

EFFECT: higher efficiency of correction.

5 dwg, 1 ex

Description

The invention relates to medicine, namely to plastic, cosmetic surgery.

Known methods when the expansion of the base of the wings of the nose is reduced due to resection of the skin segments (Piskunov S.Z., Piskunov G.Z. Cosmetic rhinoplasty / Kursk, 1996, p. 38-40; Millard DR Plast. Reconstr. Surg., 1980, vol. 65, No. 5, p. 669-672). There are also known methods where the extension of the base of the wings is reduced due to excision of the mucocutaneous segments in the same area (Converse JM Corrective and reconstructive surgery of nose. - In: Reconstructive plastic surgery (Ed JM Converse - Philadelfia, 1977, vol. 2, p .1091-1093).

However, when applying the above methods, it is not possible to make the wings of the nose thinner and more elegant. Narrowing only the base of the wings of the nose, moving the thickened wings to the correct position, it is not possible to achieve complete symmetry.

The closest way to the proposed one is the method of correction of the base of the wings of the nose (Elsahy Nabil. Plastic and reconstructive surgery of nose (Ed. Saunders - Philadelfia, 2000, p. 113-118.), Which is based on the through excision of excess skin and mucous in a single unit in base and wings of the nose.

The method adopted for the prototype has drawbacks: firstly, the hypertrophied wings of the nose move to the correct position, which shows the wings themselves at a shorter distance after excision of the skin-mucous segments as thickened and not very adjacent. Secondly, excision through the incision in the region of the base of the wings and the mucous membrane, which falls along the bottom of the nose, with the subsequent movement of the base of the thickened wings, leads to difficulty in subsequent healing and scarring of tissues, since it is very difficult to compare the edges of the wound along the bottom of the vestibule of the nasal cavity. This subsequently leads to severe scarring and narrowing of the entrance to the nasal cavity. Thirdly, the thickened wing of the nose is difficult to compare after excision of skin excesses without correction of the skin part of the wing itself, since the edges of the wound have to be pulled together with stronger seams to the correct position, which subsequently leads to more noticeable scars.

The task of the invention is to remedy these disadvantages and to use a method that would produce subtle cosmetic scars and less tissue trauma.

To do this, remove excess skin in the area of the base of the wings with spindle-shaped cuts. The lower incisions are placed in the nasolabial folds. In the presence of thickened wings along the edge of the nostrils, spindle-shaped cuts excise skin segments.

The method is as follows. After drug preparation of the patient, treatment of the surgical field with a 1% iodonate solution, markings are made in the area of the base of the wings of the nose and along the edge of the thickened wings (Fig. 2). Under Infiltration Anesthesia Sol. Lidocaini 1% - 60 ml, with the addition of 0.1% adrenaline solution in the amount of 5-6 drops, make cuts along the marking lines (Figs. 3, 4). The incision is made so that in the area of the base of the wings of the nose, it cuts only the skin and does not penetrate the mucous membrane. At one time, segments of the skin along the edge of the wings of the nose are excised with fusiform sections (Fig. 5).

These skin segments are removed, the edges of the wounds in the area of the wings themselves are mobilized. After mobilization of the edges of the wounds and the redistribution of tissues, hemostasis and the edges of the skin wounds are made, redistributing, stitching. Since, by excising excess skin in the area of the base of the wings of the nose, the mucous membrane is not injured, this does not lead later in the healing process and scarring to tighten the nasal passages. As for the scars, they are almost invisible: in the area of the base of the wings they fit into the natural nasolabial folds, and the scars that pass along the edge of the wings are also almost invisible.

According to this technique, 25 people were operated on. Long-term results were traced from 2 to 10 years. In 22 patients, the results are good, which amounted to 88%, in 3 patients - satisfactory, which amounted to 12%.

Example No. 1. Patient A-va, 33 years old (medical history No. 482), complained of a large nose, an extension of its terminal section and a wide location of the wing base (Fig. 1). On examination: the nose is enlarged due to the extension of the back, bone and cartilage humps, expansion of its end section and the base of the wings. The skin in the region of the end section of the nose is thick, and there is a thickening of the wings along the edge of the nostril (Fig. 2). After marking up and drug preparation of the patient, treatment of the surgical field with a 1% iodonate solution, under Sol. Lidocaini 1% - 20 ml. + Sol. Adrenalini 0.1% - gtt 3, the operation was performed according to the method described above. The postoperative period was uneventful. Sutures were removed on the 6-7th day from the day of surgery. The nose has become smaller: the back is even, without a hump, the end section of the nose has become more elegant, in short, the base of the wings and the wings themselves are narrower. Postoperative scars are invisible, as they are located in natural folds. As for the scars along the edge of the wings of the nose, they are also invisible, since they are located somewhat from the inside.

This method compares favorably with the prototype in that the incisions are made taking into account natural folds and excess skin is excised not only in the area of the base of the wings of the nose, but also along the edge of the nostrils, from the inside, in case of thickening, the mucous membrane is not dissected, resulting in less tissue trauma. compared to other methods.

Thus, the method, which is based on the correct understanding of the features of excess skin, cuts taking into account natural folds without cutting the mucosa, compares favorably with the prototype. The use of this method provides a lasting cosmetic result, including in the remote period after surgery. All this allows us to recommend this method in widespread practice.

Claims (1)

A method for correcting the base and wings of the nose, including excising segments of the skin in the region of the base of the wings of the nose, characterized in that the excesses of the skin of the wings of the nose are excised by spindle-shaped incisions without dissecting the mucosa, followed by a wide detachment of the dermal layer of the skin of the wings from the nasal mucosa.

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