Abstract：
Different techniques exist to provide tip support in rhinoplasty. There is little evidence to provide a consensus on the most effective choice.
Evaluating columellar strut graft (CSG) and septal extension grafts (SEG) for their influence on airway function, patient satisfaction and tip support.
A retrospective cohort study was undertaken on 165 adult patients who underwent open rhinoplasty with either a CSG or SEG, from February 2012 to August 2019 in a single tertiary facial-plastic practice in Sydney, Australia. Operations were for both cosmetic and functional indications, and both primary and revision cases were assessed. Airway testing and patient-reported outcomes (PROMs) were performed preoperatively and at least 6 months following the procedure. Photographic tip analysis was taken from approximately 4 and 12-month postoperative photographs.
Nasal peak inspiratory flow (NPIF) and total nasal airway resistance (NAR) were the primary airway functional outcomes. The primary PROMs analysed were a visual analogue scale (VAS) for nasal obstruction and 13-point Likert scale for global cosmesis, the Nose Outcome Symptom Evaluation (NOSE), and the nasal obstruction score. Tip support was determined by the nasolabial angle (NLA) and Simon\'s ratio as assessed by Rhinobase developed by Apaydin et al. on lateral Frankfort plane photographs. Data normalised as an improvement over preoperative baseline, accounting for individual variability.
A total of 165 patients was assessed (35.2 ± 12.9 yrs, 72% female), 100 (61%) of which received SEG. There were similar nasal airway assessments between CSG and SEG groups, with ΔNPIF (20.0 ± 42.1 L/min v 19.9 ± 44.9 L/min, p = 0.983) and Δ \"obstructed\" NAR (-1.13 ± 1.90 v -1.02 ± 4.33 Pa/cm3/s, p = 0.849). Amongst PROMs, a greater cosmetic outcome was seen in the SEG group (7.20 ± 2.97 v 5.69 ± 3.45, p < 0.01) with all other assessments similar between CSG and SEG techniques. Photographic analysis of tip projection showed reduced NLA distortion in the SEG.
While greater patient-perceived cosmesis was seen in patients with a SEG, there were similar airflow and patient-reported nasal function between groups. Photographic analysis of tip projection showed SEG patients additionally benefited from less NLA distortion and greater tip maintenance.
Evaluating columellar strut graft (CSG) and septal extension grafts (SEG) for their influence on airway function, patient satisfaction and tip support.
A retrospective cohort study was undertaken on 165 adult patients who underwent open rhinoplasty with either a CSG or SEG, from February 2012 to August 2019 in a single tertiary facial-plastic practice in Sydney, Australia. Operations were for both cosmetic and functional indications, and both primary and revision cases were assessed. Airway testing and patient-reported outcomes (PROMs) were performed preoperatively and at least 6 months following the procedure. Photographic tip analysis was taken from approximately 4 and 12-month postoperative photographs.
Nasal peak inspiratory flow (NPIF) and total nasal airway resistance (NAR) were the primary airway functional outcomes. The primary PROMs analysed were a visual analogue scale (VAS) for nasal obstruction and 13-point Likert scale for global cosmesis, the Nose Outcome Symptom Evaluation (NOSE), and the nasal obstruction score. Tip support was determined by the nasolabial angle (NLA) and Simon\'s ratio as assessed by Rhinobase developed by Apaydin et al. on lateral Frankfort plane photographs. Data normalised as an improvement over preoperative baseline, accounting for individual variability.
A total of 165 patients was assessed (35.2 ± 12.9 yrs, 72% female), 100 (61%) of which received SEG. There were similar nasal airway assessments between CSG and SEG groups, with ΔNPIF (20.0 ± 42.1 L/min v 19.9 ± 44.9 L/min, p = 0.983) and Δ \"obstructed\" NAR (-1.13 ± 1.90 v -1.02 ± 4.33 Pa/cm3/s, p = 0.849). Amongst PROMs, a greater cosmetic outcome was seen in the SEG group (7.20 ± 2.97 v 5.69 ± 3.45, p < 0.01) with all other assessments similar between CSG and SEG techniques. Photographic analysis of tip projection showed reduced NLA distortion in the SEG.
While greater patient-perceived cosmesis was seen in patients with a SEG, there were similar airflow and patient-reported nasal function between groups. Photographic analysis of tip projection showed SEG patients additionally benefited from less NLA distortion and greater tip maintenance.
摘要：
存在不同的技术来在隆鼻中提供尖端支撑。几乎没有证据可以就最有效的选择达成共识。
评估小柱支撑移植物（CSG）和间隔延长移植物（SEG）对气道功能的影响，患者满意度和小费支持。
对165例接受CSG或SEG开放性隆鼻手术的成年患者进行了回顾性队列研究，从2012年2月到2019年8月，在悉尼进行了一次三级面部整形练习，澳大利亚。手术是为了美容和功能适应症，并对主要病例和修订病例进行了评估.术前和手术后至少6个月进行气道测试和患者报告的结果（PROM）。从大约4个月和12个月的术后照片中获取摄影尖端分析。
鼻峰值吸气流量（NPIF）和总气道阻力（NAR）是主要的气道功能结果。分析的主要PROM是鼻塞的视觉模拟量表（VAS）和全球宇宙的13点Likert量表，鼻预后症状评估(NOSE),和鼻塞评分。尖端支持由Apaydin等人开发的Rhinobase评估的鼻唇沟角度（NLA）和Simon's比率确定。在横向法兰克福飞机照片上。数据标准化为术前基线的改善，考虑个体差异。
共评估了165例患者（35.2±12.9岁，72%女性），100人（61%）收到SEG。CSG和SEG组之间的鼻气道评估相似，ΔNPIF（20.0±42.1L/minv19.9±44.9L/min，p=0.983)和Δ“阻塞”NAR(-1.13±1.90v-1.02±4.33Pa/cm3/s,p=0.849)。在PROMs中，在SEG组中观察到更大的美容结果(7.20±2.97v5.69±3.45,p<0.01),CSG和SEG技术之间的所有其他评估相似.尖端投影的摄影分析显示SEG中NLA畸变减少。
虽然在SEG患者中看到了更大的患者感知外观，两组间气流和患者报告的鼻功能相似.尖端投影的摄影分析显示，SEG患者还受益于更少的NLA变形和更多的尖端维护。
评估小柱支撑移植物（CSG）和间隔延长移植物（SEG）对气道功能的影响，患者满意度和小费支持。
对165例接受CSG或SEG开放性隆鼻手术的成年患者进行了回顾性队列研究，从2012年2月到2019年8月，在悉尼进行了一次三级面部整形练习，澳大利亚。手术是为了美容和功能适应症，并对主要病例和修订病例进行了评估.术前和手术后至少6个月进行气道测试和患者报告的结果（PROM）。从大约4个月和12个月的术后照片中获取摄影尖端分析。
鼻峰值吸气流量（NPIF）和总气道阻力（NAR）是主要的气道功能结果。分析的主要PROM是鼻塞的视觉模拟量表（VAS）和全球宇宙的13点Likert量表，鼻预后症状评估(NOSE),和鼻塞评分。尖端支持由Apaydin等人开发的Rhinobase评估的鼻唇沟角度（NLA）和Simon's比率确定。在横向法兰克福飞机照片上。数据标准化为术前基线的改善，考虑个体差异。
共评估了165例患者（35.2±12.9岁，72%女性），100人（61%）收到SEG。CSG和SEG组之间的鼻气道评估相似，ΔNPIF（20.0±42.1L/minv19.9±44.9L/min，p=0.983)和Δ“阻塞”NAR(-1.13±1.90v-1.02±4.33Pa/cm3/s,p=0.849)。在PROMs中，在SEG组中观察到更大的美容结果(7.20±2.97v5.69±3.45,p<0.01),CSG和SEG技术之间的所有其他评估相似.尖端投影的摄影分析显示SEG中NLA畸变减少。
虽然在SEG患者中看到了更大的患者感知外观，两组间气流和患者报告的鼻功能相似.尖端投影的摄影分析显示，SEG患者还受益于更少的NLA变形和更多的尖端维护。
