功能性鼻填充剂后鼻呼吸的逐步评估：一项基于峰值鼻吸气流量计的前瞻性研究。

文献信息

中文摘要

背景： 使用透明质酸（HA）填充剂的非手术鼻整形术广泛用于鼻部美学矫正；然而，其对鼻呼吸功能的潜在影响仍未被充分探索。鼻尖和鼻小柱的结构改变可能影响外鼻瓣和鼻气流动力学。
目的： 使用客观和主观评估工具，前瞻性评估两步法HA鼻填充剂技术对鼻呼吸的功能影响，并确定鼻小柱和鼻尖填充各自的贡献。
方法： 九名因鼻尖支撑减弱而存在功能性鼻呼吸障碍的成年女性患者接受了标准化的两步法鼻填充剂手术。九名因美学鼻部问题寻求非手术鼻填充剂治疗、同时伴有不同程度主观鼻塞的成年女性患者接受了标准化的两步法鼻填充剂手术。在鼻小柱和鼻尖依次进行HA注射。在基线、第一次注射后和第二次注射后，使用峰值鼻吸气流量（PNIF）测量客观鼻气流。在基线、10天和60天时，使用视觉模拟量表（VAS）评估主观呼吸质量。
结果： 鼻小柱注射后平均PNIF显著增加（+17.7%），鼻尖填充后进一步显著改善（+5.4%），与基线相比总体PNIF增加24.0%。主观VAS评分在10天时显著改善，并在60天时仍显著高于基线。未观察到并发症。
结论： 使用HA的靶向两步法功能性鼻填充剂方案可以显著改善鼻气流和患者感知的呼吸质量。鼻小柱填充似乎提供最大的功能益处，支持鼻填充剂作为特定患者微创功能干预的概念。

英文摘要

BACKGROUND: Nonsurgical rhinoplasty with hyaluronic acid (HA) fillers is widely used for aesthetic nasal correction; however, its potential impact on nasal respiratory function remains underexplored. Structural alterations of the nasal tip and columella may influence the external nasal valve and nasal airflow dynamics.
OBJECTIVES: To prospectively evaluate the functional effects of a two-step HA rhinofiller technique on nasal breathing using objective and subjective assessment tools, and to determine the individual contribution of columellar and nasal tip augmentation.
METHODS: Nine adult female patients with functional nasal breathing impairment related to reduced tip support underwent a standardized two-step rhinofiller procedure. Nine adult female patients seeking nonsurgical rhinofiller treatment for aesthetic nasal concerns, with concomitant varying degrees of subjective nasal obstruction, underwent a standardized two-step rhinofiller procedure. Sequential HA injections were performed at the columella and nasal tip. Objective nasal airflow was measured using peak nasal inspiratory flow (PNIF) at baseline, after the first injection, and after the second injection. Subjective breathing quality was assessed using a visual analog scale (VAS) at baseline, at 10 days, and at 60 days.
RESULTS: Mean PNIF increased significantly after columellar injection (+17.7%) and showed a further significant improvement following nasal tip augmentation (+5.4%), resulting in an overall PNIF increase of 24.0% compared with baseline. Subjective VAS scores improved significantly at 10 days and remained significantly higher than baseline at 60 days. No complications were observed.
CONCLUSIONS: A targeted two-step functional rhinofiller protocol using HA can significantly improve nasal airflow and patient-perceived breathing quality. Columellar augmentation appears to provide the greatest functional benefit, supporting the concept of rhinofiller as a minimally invasive functional intervention in selected patients.