Open-Roof Deformity: How to Avoid, How to Cure?

Basem Damanhouri, Nuray Bayar Muluk, Cemal Cingi
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Abstract

Objectives: Of all the face surgeries, rhinoplasty is known to be the most difficult. The aim of this paper is to review open-roof deformity. Methods: PubMed, EBSCO, UpToDate, Proquest Central at Kırıkkale University, and Google and Google Scholar were used in the literature review. The search was performed with the keywords "open roof deformity," "rhinoplasty," "fillers" between 2024 and 1980. Results: Rhinoplasty is a surgery that requires a combination of art and science, unlike other procedures that may have challenging anatomic access, requiring an excessive amount of physical strength, or a long operating period that causes surgeon fatigue. It is common for people undergoing primary rhinoplasty to have their hump removed, which can lead to open-roof deformity. Lateral osteotomies and the use of grafts are crucial in the prevention of open-roof abnormalities. It is common practice to perform lateral osteotomies to seal this space. However, lateral osteotomy becomes tricky when the patient's bony vault is small. Another well-known option is to shape and replace the hump or to use a spreader graft, flap, sliced cartilage, or some combination of these. HA filler can also be administered to achieve the same effect as a spreader graft. Along the length of the dorsum on both sides, HA is injected retrogradely. Conclusion: If there are dorsal irregularities after surgery or if there is a need to fix the look of nasal bridge, this therapy can help.

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开屋顶畸形:如何避免,如何治疗?
目的:众所周知,在所有面部手术中,鼻整形手术是最困难的。本文旨在对开颅畸形进行综述。研究方法文献综述使用了 PubMed、EBSCO、UpToDate、克勒克卡莱大学 Proquest Central 以及 Google 和 Google Scholar。搜索关键词为 2024 年至 1980 年间的 "鼻顶开放畸形"、"鼻整形术"、"填充物"。结果:鼻整形手术是一项需要艺术与科学相结合的手术,与其他手术不同的是,鼻整形手术可能对解剖学入路具有挑战性,需要过多的体力,或手术时间过长导致外科医生疲劳。接受初级鼻整形手术的人通常会切除驼峰,这可能会导致开颅畸形。侧截骨术和移植物的使用对于预防开颅畸形至关重要。通常的做法是进行外侧截骨来封闭这一空间。然而,当患者的骨穹隆较小时,侧方截骨术就变得非常棘手。另一种众所周知的方法是对驼峰进行塑形和置换,或使用扩张器移植、皮瓣、软骨切片或这些方法的组合。也可以使用 HA 填充剂来达到与扩张器移植相同的效果。沿着两侧背骨的长度,逆行注射 HA。结论如果术后鼻背不整齐或需要修复鼻梁外观,这种疗法可以起到帮助作用。
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