高位与低位鼻中隔保留式鼻整形术：鼻背驼峰-鼻尖上区动态的定量形态学分析

文献信息

中文摘要

背景： 保留式鼻整形术因能获得自然的鼻背轮廓而日益受到关注。高位鼻中隔和低位鼻中隔入路是两种主要术式，但比较性临床数据仍然有限。
目的： 采用标准化的鼻尖上区与鼻背驼峰测量方法，对高位鼻中隔与低位鼻中隔保留式鼻整形术进行定量比较，并评估其与术式相关生物力学行为及鼻背轮廓变化的关系。
方法： 回顾性分析2022年至2024年间接受保留式鼻整形术的30例患者，并按术式（高位鼻中隔 vs. 低位鼻中隔）进行分类。对标准化的侧面照片进行分析，以量化驼峰和鼻尖上区高度。采用四项参数比较两种入路之间以及每种术式内部的鼻尖上区与驼峰降低情况，其中包括角度测量。统计分析包括Mann-Whitney U检验、t检验、描述性统计和协方差分析（ANCOVA）。
结果： 前两项参数显示两种术式在鼻尖上区下降方面存在统计学显著差异，高位鼻中隔组下降更明显，而低位鼻中隔组鼻尖上区位置相对较高。第三项参数显示出不同的反应：在高位鼻中隔组，鼻尖上区变化随驼峰降低程度增大而减小，而在低位鼻中隔组则增大。第四项参数以角度形式捕捉鼻尖上区-驼峰行为，低位鼻中隔组数值较高，高位鼻中隔组数值较低。
结论： 本研究提供了高位鼻中隔与低位鼻中隔保留式鼻整形术的客观人体测量学比较，并证明两种入路在鼻尖上区比例反应上存在差异。这些发现可能有助于加深对术式相关鼻背轮廓行为的理解，并辅助手术规划。
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英文摘要

BACKGROUND: Preservation rhinoplasty is gaining attention for achieving natural dorsal contours. High septal and low septal approaches are two main variants, yet comparative clinical data remain limited.
OBJECTIVES: To quantitatively compare high septal and low septal preservation rhinoplasty using a standardized supratip and dorsal hump measurement method and to evaluate their relationship with technique-related biomechanical behavior and dorsal contour changes.
METHODS: Thirty patients who underwent preservation rhinoplasty between 2022 and 2024 were retrospectively reviewed and categorized by technique (high septal vs. low septal). Uniform lateral photographs were analyzed to quantify hump and supratip heights. Four parameters were used to compare supratip and hump reduction between approaches and within each technique, including angular measurements. Statistical analyses included Mann-Whitney U tests, t tests, descriptive statistics and ANCOVA.
RESULTS: The first two parameters demonstrated statistically significant differences in supratip descent between techniques, with greater lowering in the high septal group and a relatively higher supratip position in the low septal group. The third parameter showed divergent responses: supratip change diminished with greater hump reduction in the high septal group but increased in the low septal group. The fourth parameter captured supratip-hump behavior in angular form, with higher values in the low septal group and lower values in the high septal group.
CONCLUSIONS: This study provides an objective anthropometric comparison of high septal and low septal preservation rhinoplasty techniques and demonstrates differing proportional supratip responses between approaches. These findings may improve understanding of technique-related dorsal contour behavior and assist surgical planning.
LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .