RU2583249C2 - Method for open reduction rhinoplasty - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to plastic surgery. The columella skin W-incision is made and extended into under-wing spaces. A mucosupracartilaginous flap is separated. A bone-cartilaginous nasal frame is separated. That is followed by an inspection procedure. A wedge resection is performed in a middle one-third of a nasal septum in the bone-cartilaginous portion with a triangle base lying on a front edge of the nose and an apex at the root of the nose. A straight osteotome is used for a symmetrical plane dissection of the cartilage and bone portions of the lateral nasal walls. The bone-cartilage complex of a nasal arch is brought down at the preset distance. A duplication of the bone and cartilaginous portions of the lateral nasal walls is formed. The nasal septum is matched end-to-end. The nasal septum is fixed in the cartilage portion with an interrupted suture. Inner sutures are applied on cartilages and nasal passage mucosa with absorbable non-traumatic suture material No.5/0. The columella skin is sutured with absorbable non-traumatic monofilament No. 6/0. That is followed by an anterior nasal swabbing with synthomycin ointment. The nasal arch is splinted and covered with an aseptic dressing.

EFFECT: method enables improving the functional and aesthetic effect of the rhinoplasty, reducing the operation-related injuries and preserving the anatomical integrity of the nasal structures by the wedge resection of the nasal septum in its middle one-third and changing the nose shape by proper tissues.

3 dwg, 2 ex

Description

The invention of the “method of open reduction rhinoplasty” relates to medicine, namely to plastic surgery.

Purpose: increasing the effectiveness of rhinoplasty in the presence of certain indications for surgery, from an aesthetic and functional point of view.

Tasks:

- reducing the invasiveness of the operation;

- minimization of violations of the anatomical integrity of the structures of the nose;

- preservation of the integrity and naturalness of the structures of the nose;

- a change in the shape of the nose due to existing tissues.

Relevance:

In the concept of appearance, the shape of the nose occupies a leading position throughout the history of the development of civilization.

The need to increase the effectiveness of rhinoplasty surgery is explained by increased requirements for the appearance of a modern person. A person harmonious from aesthetic and anatomical positions is the key to success in professional, personal and social activities.

The closest analogue of the invention is a method of reducing rhinoplatitis disclosed in the work of D. Zimin Reduction rhinoplasty. Bulletin of the Northern State University No. 1 (Issue XXVIII), 2012, pp. 7-9 (1).

Description:

A W-shaped incision of the columella skin is carried out with continuation into the axillary spaces, the mucocartilaginous flap is separated, the bone-cartilaginous frame of the nose is distinguished, an audit is performed (Fig. 1).

A wedge-shaped resection is performed in the middle third of the nasal septum in the osteo-cartilaginous section with the base of the triangle on the front edge of the cartilage of the nasal septum and the apex at the root of the nose (5), with symmetrical planar chondro-osteotomy (6) in the region of the noses of the nose with a direct osteotome (Figure 2 ) The osteo-cartilaginous complex of the nasal dorsum drops down by a pre-calculated value. Duplicates of the cartilaginous and bone parts of the nose slopes are formed (7), the septum is aligned edge to edge, fixing it in the cartilaginous section with a nodal suture (8) (Figure 3).

Resection of the medial and lateral legs of the wing cartilage is performed according to the standard method, and the columella and the back of the nose are formed. Internal seams and sutures on the mucous membrane of the nasal passages are superimposed by absorbable atraumatic suture material No. 5/0, and on the skin of the columella by non-absorbable atraumatic suture No. 6/0. Anterior nasal swab with syntomycin ointment. The application of a longy on the back of the nose and aseptic dressings.

Examples:

1. Patient M., 24 years old.

Diagnosis: hypertrophy of all parts of the nose.

Achieved: reduction rhinoplasty with open access.

The postoperative period was favorable, without features. The tampons were removed and the sutures were removed on the 5th and 7th day after the operation, respectively.

Result: immediate and long-term results are satisfactory from an aesthetic and functional point of view (nasolabial angle 110 °, nasolabial angle 120 °, which corresponds to the norm).

2. Patient R., 32 years old.

Diagnosis: hypertrophy of all sections of the nose, hump of the nasal bridge, deviation of the nasal septum to the left.

Achieved: reduction rhinoplasty with open access.

The postoperative period was favorable, without features. The tampons were removed and the sutures were removed on the 5th and 7th day after the operation, respectively.

Result: immediate and long-term results from an aesthetic and functional point of view are satisfactory (nasolabial angle of 100 °, nasolabial angle of 120 °, which corresponds to the norm).

Information sources

1. Zimin D.A. Reduction rhinoplasty. Bulletin of the Northern State University No. 1 (Issue XXVIII), 2012, pp. 7-9.

2. V. Tapia-Fernandez. Atlas of Plastic Surgery: External Nasal Surgery, Open Rhinoplasty, TAPIA.

3. Plastic and reconstructive surgery of the face / Ed. HELL. Peypla. Per. from English - M .: BINOM. Laboratory of Knowledge, 2007. - 951 p.

Brief Description of the Drawings

1 - the bone part of the nasal septum;

2 - cartilaginous part of the nasal septum;

3 - wing cartilage;

4 - line of fusion of bone and cartilage of the nasal septum;

5 - zone of resection of the nasal septum;

6 - line planar chondro-osteotomy;

7 - duplicate cartilage and bone part of the nose;

8 - nodal suture in the cartilaginous part of the nasal septum.

Claims (1)

The method of open reduction rhinoplasty, which consists in performing a W-shaped incision of the columella skin with extension into the underwing spaces, separating the mucous-perchondral flap, isolating the bone-cartilaginous skeleton of the nose, performing an audit, performing a resection of the septum and dissecting the cartilaginous and bone parts of the nose and the resection of the medial and lateral legs, the formation of columella and the back of the nose, the imposition of internal sutures on the cartilage and on the mucous membrane of the nasal passages with absorbable atraumatic suture material No. 5 / 0, sutures on the skin of columella with non-absorbable atraumatic monofilament No. 6/0, anterior nasal swab with synthomycin ointment, application of a splint on the back of the nose and aseptic dressing, characterized in that they perform wedge-shaped resection in the middle third of the nasal septum in the bone-cartilaginous section with a base on the front edge of the cartilage of the nasal septum and the apex at the root of the nose with a symmetrical planar dissection of the cartilaginous and bone parts of the nasal chutes with a direct osteotome, lower the bone-cartilaginous complex of the nasal dorsum down by the calculated value, form a duplicate of the cartilaginous and bone parts of the nose slopes, comparing the septum edge to edge, fix it in the cartilage section with a nodal suture.

Images