Scroll Ligament Repair in Dorsal Preservation Rhinoplasty: A Cartilage as a Guide on Nasal Skin Envelope for Suturing

IF 2.8 3区医学 Q2 SURGERY Aesthetic Plastic Surgery Pub Date : 2025-02-18 DOI:10.1007/s00266-025-04717-y

Yavuz Tuluy, Vasfi Çelik, Aziz Parspancı, Emin Sır

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Abstract

Background

The scroll ligament provides support to the internal and external valve, and its repair in rhinoplasty provides good functional and aesthetic results. In this study, it was aimed to repair the scroll ligament complex by leaving cartilage in the nasal skin envelope, and clinical results were shared.

Patients and Methods

216 patients who underwent closed preservation rhinoplasty with modified low septal strip septoplasty were included in the study. A 10 x 1 mm of cartilage is left in the nasal skin envelope at the midpoint of the cranial part of the lateral crus of the LLC, leaving it as a guide to repair the scroll ligament complex in the anatomically correct place. Demographic data, complications, revision surgeries, follow-up periods and satisfaction of the patients were analyzed retrospectively.

Results

Residual humps were observed in 2 patients. Inferior turbinate hypertrophy was observed in 4 patients. In 1 patient, total septal reconstruction was performed. Two hundred and three patients were evaluated the results as poor, moderate, good and very good. One hundred and sixteen patients rated the functional outcome as very good, 80 patients as good, 4 patients as moderate and 3 patients as poor. One hundred and twenty-eight patients rated the aesthetic result as very good, 72 as good and 3 as moderate.

Conclusion

Repairing the scroll ligament complex provides both internal and external valve support, better redraping and eliminating the dead space. Leaving cartilage on the nasal skin envelope as a guide helps to repair the scroll ligament complex in the anatomically correct place at the end of the surgery.

Level of Evidence IV

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.

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背侧保留鼻成形术中卷轴韧带修复：以软骨为导向的鼻皮肤包膜缝合。

背景：涡旋韧带为内、外瓣膜提供支撑，其修复在鼻整形术中具有良好的功能和美观效果。本研究旨在通过在鼻腔皮肤包膜中保留软骨修复涡旋韧带复合物，并分享临床结果。患者和方法：216例采用改良低鼻中隔条状鼻中隔成形术的闭合性保存鼻成形术患者纳入研究。在LLC外侧脚颅部中点的鼻皮肤包膜中留下一个10 x 1 mm的软骨，作为在解剖正确位置修复卷轴韧带复合物的指导。回顾性分析患者的人口学资料、并发症、翻修手术、随访时间及满意度。结果：2例患者观察到残留的驼峰。4例患者下鼻甲肥大。1例患者行全间隔重建。203例患者被评价为差、中等、良好和非常好。116名患者将功能结果评为非常好，80名患者为好，4名患者为中等，3名患者为差。128名患者认为美学效果非常好，72名为好，3名为中等。结论：修复涡旋韧带复合体可提供内外瓣膜支撑，更好地重垂，消除死腔。在鼻皮肤包膜上留下软骨作为指导，有助于在手术结束时在解剖正确的位置修复卷轴韧带复合物。证据等级iv：本刊要求作者为每篇文章指定一个证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者说明www.springer.com/00266。

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来源期刊

Aesthetic Plastic Surgery 医学-外科

CiteScore

4.40

自引率

25.00%

发文量

479

审稿时长

3 months

期刊介绍： Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP). Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships. Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.