Facial Plastic Surgery & Aesthetic Medicine最新文献

The authors propose a novel variation of the Spare Roof Technique for Preservation Rhinoplasty-"NOVA Spare Roof Technique." This modification involves a newly developed maneuver, the Sail Maneuver, which is a simple rhinoplasty technique for treating dorsal humps without lateral keystone area disarticulation. The authors find that this rhinoplasty strategy can be a precise surgery for a smooth and natural dorsum with a natural transition on the dorsal keystone area and, simultaneously, can improve the dorsal aesthetic lines (DALs). This approach is based on the new "dorsal vectorial concept" in rhinoplasty. A patient with a dorsal hump on a profile view can have a significant impact on the vector of the DALs. This rhinoplasty approach addresses that problem with a mathematical rationale.

Background: A systematic comparison between the preservation rhinoplasty (PR) and the conventional structural rhinoplasty (SR) technique for hump nose correction is still lacking. Objective: To compare among patients undergoing rhinoplasty for dorsal hump correction using structural versus preservation techniques, as measured by functional and cosmetic patient-reported outcomes. Methods: Comprehensive literature search was conducted across PubMed, Medline, Embase, and Cochrane databases using medical subject heading terms. Among patients undergoing dorsal hump reduction, we analyzed randomized controlled trials (RCTs) comparing PR and SR to assess functional and cosmetic satisfaction using the Standardized Cosmesis and Health Nasal Outcomes Survey, and the visual analogue scale. Results: Among the 38 studies initially screened, four RCTs with 419 patients met the inclusion criteria. PR showed significant superiority over SR in both functional (standardized mean difference or SMD -0.317 [95% confidence interval or CI -0.509 to -0.124]) and cosmetic (SMD -0.460 [95% CI -0.851 to -0.069]) outcomes. Functional outcomes exhibited low heterogeneity (I² = 0%), while cosmetic outcomes showed moderate heterogeneity (I² = 67%). Conclusion: In this review, the data suggest that PR might provide both functional and cosmetic satisfactions in dorsal hump reduction compared with SR.

Importance: Bell's palsy (BP) is reported as the most common cause of facial paralysis, yet literature lacks a standardized definition of BP. Objective: To identify and categorize how the term "Bell's palsy" is defined and applied in published medical literature. Evidence Review: Randomized controlled trials, clinical trials, systematic reviews, meta-analyses, and reviews containing "Bell's palsy" were identified in MEDLINE, Embase, and CENTRAL databases from inception until April 2, 2024. Articles were indexed by their definition of BP: (1) acute (≤72-h onset) idiopathic facial paralysis with no known etiologies, (2) acute "idiopathic" facial paralysis despite providing etiologies, (3) acute non-idiopathic facial paralysis, (4) non-acute but "idiopathic" facial paralysis with or without providing etiologies, (5) synonymous with facial paralysis, and (6) no definition. Ascribed etiologies were recorded. Original articles' exclusion criteria for patients with BP were also categorized. Findings: Of 4,395 articles obtained, 924 met the criteria. Based on the aforementioned categories, incongruent definitions of BP exist in the literature: (1) 12.88%, (2) 14.72%, (3) 4.00% (4) 15.26%, (5) 8.12%, and (6) 45.02%. Ascribed etiologies and exclusion criteria for BP also varied. Conclusions and Relevance: BP is a common condition seen by providers of many specialties, and as such patient diagnosis, management, and research rely on consistency and a shared language. This systematic review found inconsistent definitions and applications of the term "Bell's palsy" in the literature.

Background: Functional rhinoplasty often relies on repurposed cartilage for nasal framework grafting. Objective: To compare complications in functional rhinoplasty associated with use of autologous versus fresh frozen cadaveric rib cartilage (FFCR). Methods: This retrospective cohort study included patients who underwent functional rhinoplasty from 2017 to 2022 with 6 months of documented follow-up. The primary outcome measure was need for revision rhinoplasty. Secondary outcomes were infection and persistent nasal obstruction without revision surgery. Chi-squared and Fisher's exact tests were used for univariate analysis, and multivariable logistic regression was used to evaluate the relationship between revision surgery and covariates. Results: 259 patients (average age: 43.1 ± 16.2, 185/259 female [71.4%]) underwent functional rhinoplasty with an average of 12.3 months (range: 6-54 months) of documented follow-up. A total of 58 (22.4%) cases utilized FFCR for grafting. Overall, 15 (5.8%) patients required revision rhinoplasty (8/201 [4.0%] autologous versus 7/58 [12.1%] FFCR), while 17 (6.6%) had persistent postoperative nasal obstruction without further surgery and 12 (4.6%) had an infection requiring prescribed oral antibiotics or drainage. Compared to autologous cartilage, there was a significant association between the use of FFCR with revision rhinoplasty on logistic regression (p = 0.024, odds ratio: 4.0 [95% confidence interval: 0.17-2.61]) but not with postoperative infection (p = 0.101) or persistent nasal obstruction (p = 0.187). Conclusion: These findings suggest increased rates of revision surgery associated with the use of FFCR in functional rhinoplasty. In the setting of insufficient autologous cartilage, tailored discussions should take place regarding the risks and benefits of potential supplemental graft material.