유영천·김도형
경희대학교
의과대학 성형외과학교실
Effectiveness
of Decortication Septorhinoplasty via External Approach
Young
Cheun Yoo, M.D., Do Hyung Kim, M.D.
Department
of Plastic and Reconstructive Surgery,
College
of Medicine, KyungHee University, Seoul, Korea
The
purpose of this article is to describe an alternative
approach to the nasal septum and the advantages
offered by the decortication septorhinoplasty in
correcting difficult nasal deformities. Using the
decortication septorhinoplasty approach, the entire
cartilagenous septum can be exposed so that each
specific deformity can be visualized and corrected
appropriately. Retracting the lateral crura laterally,
a midline plane is dissected, and the anterior septal
angle and dorsal margin of the septal cadilage is
identified. The elevation of the mucoperichondrium
is started at the area of the anterior septal angle.
After anterior approach, scissors are inserted between
the septal cartilage and the upper lateral cartilage
and their junction is sharply divided. Elevation
of the rest of the
mucoperichondrium is completed as a skeletonized
single unit. Sculpting the entire cartilagenous
and/or bony vault as well as correcting difficult
septal malalignments, can be carried out under
better direct vision with great precision, accuracy,
and predictability. From January 2000 till
Match 200l the decortication approach is used for
correcting difficult nasal deformity in 24 patients.
Or these, 5 are secondary cleft lip nose, l0 are
deviated nose, 5 are traumatic saddle nose, and
4 are hump nose. The mean follow up period is l2
months, ranging from 5 to 20 months. The patients
are overall satisfied with the aesthetic and functional
results.
The
disadvantage and complication of the decortication
septorhinoplasty is the same as compared to the
conventional open rhinoplasty. The decortication
approach is most suited for correction of deformities
at the dorsal aspect of the nasal septum that causes
a twisted nose deformity, of deformities at
the anterior septal angle causing
an asymmetric tip, and of deformities along
the caudal aspect of the quadrangular cartilage
producing columellar distortion, and of relational
deformities between anterior nasal spine and septum.
The decortication technique has provided a effective
avenue for the correction of severe nasaI deformities.
Key
words : Decortication septorhinoplasty, External
rhinoplasty |
