585名汉族成人外鼻形态测量意义

我们从临床实用角度出发，对西宁地区５８５名汉族成年健康人的鼻外形态学测量，得出一组鼻形态常规，供整形美容手术设计时参考，并对测量中的某些问题阐明了我们的观点。     

现代汉族正常青年女性外鼻形态学测量研究

目的 通过对现代汉族正常青年女性人群外鼻形态进行针对性测量和深入分析,探讨不同人种存在的差异.方法 本研究选择在大连地区的两所高校,随机抽取了在校就读的汉族正常女性大学生320例.年龄18～22岁.采集拍摄正位像、侧位像、基底位像3组数码彩色照片,根据研究设计选择了17个外鼻软组织测量标记点(非成对标志点9个,成对标志点8个),在计算机上应用Adobe Photoshop CS5软件定点测量了16个线性距离项目(成对测量项目4对)和4个角度项目.结果 计算线距、角度和比例指数的±s,并与已公布的标准北美白人女性外鼻的测量数据进行种族的比较.其中,现代汉族正常青年女性的外鼻6个线性距离较大,6个线性距离较小;鼻额角、鼻尖角、鼻面角较大,鼻唇角较小;9个比例指数中,汉族鼻指数和鼻宽-鼻长指数较大,其余7个鼻比例指数均较小.上述所有测量数据除鼻翼长-鼻高指数,P ＞0.05无统计学意义;其余所有的测量结果,P ＜0.01有统计学意义.结论 中国汉族女性与北美白人女性的外鼻测量结果 存在着明显的差异,汉族女性鼻部特征不符合以白人作为研究对象建立起来的古典美学标准,为临床鼻部整形手术提供量化指标和参考依据.     

585名汉族成人外鼻形态测量意义

我们从临床实用角度出发,对西宁地区585名汉族成年健康人的鼻外形态学测量,得出一组鼻形态常规,供整形美容手术设计时参考,并对测量中的某些问题阐明了我们的观点。     

昆明地区汉族正常青年女性眼和鼻外形测量研究

目的：对昆明地区汉族正常青年女性眼、鼻外形进行测量，了解其形态特征.方法：选择昆明籍年龄18～22岁面部形态正常的汉族青年女性120名，采用Martin人体测量方法对眼、鼻进行表面测量.结果：获得14项测量的正常值范围，与湖南等地区正常青年女性及云南彝族、傣族青年女性测量值存在一定差异.结论：眼、鼻外形表面测量值有地区和民族的差异，临床应用中应有不同的标准。     

汉族正常年轻成年女性外鼻软组织测量及比较研究

目的 通过对汉族正常年轻成年女性外鼻软组织的测量和分析,将其同LG Farkas等针对北美白人女性的外鼻软组织测量数据进行比较,为外鼻部整形手术提供客观可靠的数据参考.方法 选择长沙地区就读的汉族正常女大学生63例.年龄18～25岁,平均23岁.以LG Farkas的头面部测量研究为基础,选择10个测量标记点和6个比例指数,对13个测量项目(10个线性距离,3个角度)进行测量.结果 计算测量项目和比例指数的均数和标准差,并进行种族间的比较.其中,5个线性距离较大(P<0.01),5个线性距离较小(P<0.01);鼻额角及鼻尖角较大,鼻唇角较小(P<0.01);6个比例指数中,鼻深-鼻宽指数、鼻翼长-鼻高指数、鼻小柱宽-鼻宽指数及鼻小柱高度-鼻深指数较小(P<0.01),鼻指数较小(P<0.05),鼻梁指数较小,其差异无统计学意义(P>0.05).结论 中国汉族女性与北美白人女性的外鼻软组织存在明显的差异.本研究可以为外鼻部整形手术提供有参考价值的外鼻软组织的正常值.     

自然站立位与卧位枕高相关参数的测量研究

目的探讨睡眠时合适枕头高度的测量方法。方法对43例健康成人进行自然站立位和卧位2种状态下的枕头高度相关参数进行测量。结果在自然站立位立正姿式和双手抱肩姿式下测得的肩-面距明显大于侧枕高,自然站立位测得的枕-背距明显大于仰枕高度;在卧位状态下,侧枕高度明显高于仰枕高度;在合适枕高下,卧位的颈椎生理曲度存在,曲线良好,且与自然站立位没有显著差别（P〉0．05）。结论在卧位下,采用合适的枕高,颈椎可以保持良好的生理弧度,与自然站立位状态下颈椎的生理弧度比较没有显著的差别;睡眠时仰枕高度应该低于侧枕高度.     

多平面注射透明质酸鼻整形的临床研究

目的 通过在鼻梁不同部位不同层次注射透明质酸,以改善鼻部外观形态,达到满意的鼻整形效果.方法 在鼻骨部于骨膜下或骨膜上,软骨部于软骨膜上,鼻尖部于大翼软骨间注射透明质酸,以垫高鼻背和鼻尖.根据鼻部形态及求美者的审美要求确定注射剂量,遵循宁少勿多的原则,若不足可于首次注射后1周内补充注射,本组病例注射总量为1 ～1.5 ml.结果 2010年1月至2012年1月,共进行透明质酸注射鼻整形60例,未发现患者有特别的不良反应,未出现肿胀外观,术后随访10 ～ 13个月,效果均较满意,42例能维持9个月左右,最长12个月,1例在6个月消失.结论 透明质酸多层次注射隆鼻效果确实,可以达到更真实的鼻整形效果.     

外鼻整形术在鼻翼退缩分型患者中的应用效果

目的 观察外鼻整形术在鼻翼退缩分型患者中的应用效果。方法 选取四川悦好医学美容医院美容 外科2021年1月-2023年1月收治的60例鼻翼退缩分型患者,按照随机数字表法分为对照组和观察组,各 30例。对照组行鼻孔缩小术,观察组行外鼻整形术,比较两组外鼻整形参数、鼻美学指标、临床疗效、鼻 通气功能指标、鼻外形畸形情况、鼻腔通气评分及并发症发生情况。结果 观察组鼻长、理想鼻长、额鼻 角、鼻唇角优于对照组,差异有统计学意义（P＜0.05）;观察组鼻尖突出度高于对照组,鼻孔暴露度低于 对照组,差异有统计学意义（P ＜0.05）;观察组治疗总有效率为96.67%,高于对照组的86.67%,差异有 统计学意义（P ＜0.05）;观察组鼻腔最小截面积、鼻腔容积、鼻腔呼气吸气阻力各项鼻通气功能指标优 于对照组,差异有统计学意义（P ＜0.05）;观察组鼻外形畸形评分、鼻腔通气评分低于对照组,差异有 统计学意义（P ＜0.05）;两组均未见并发症发生。结论 外鼻整形术在鼻孔暴露度鼻翼退缩分型患者中的 应用效果优于鼻孔缩小术,对改善患者鼻孔暴露度、鼻部美观度等具有积极作用,更具临床应用价值。     

鼻整形术对整形美容受术者体像影响的初步研究

目的：探讨鼻整形术对受术者体像的影响,研究体像障碍检出者鼻整形手术前后的体像变化。方法：采用体像障碍自评量表,对108名受术者于鼻整形手术前后进行问卷调查,分析结果。结果：受术者鼻整形手术前体貌关注度、情绪受损度和社会交往度三组指标的平均分值位于前列。体像障碍在鼻整形术受术者中的检出率为16.7%。全部受术者手术前的量表评分为19.23±11.69,手术后下降为15.89±10.26（P〈0.01）;体像障碍检出者的术前量表评分为45.36±5.27,手术后下降为31.08±9.14（P〈0.05）,术后评分降低的指标集中反映在躯体缺陷感、情绪受损度和社会交往度三个方面。结论：鼻整形术受术者手术前对自身体像极为关注,情绪受损严重,鼻整形术能够明显改善受术者的体像状态。体像障碍在鼻整形术受术者中的检出率较高,鼻整形术有助于体像障碍受术者消除消极体像。     

内镜辅助歪鼻矫正术

目的探讨内镜在面部轮廓改形中的临床应用价值。方法在内镜辅助下对12例歪鼻求术者鼻骨支架进行截骨改形,松解外在及内在牵拉力量,复位鼻骨、矫直鼻中隔,重塑鼻支架。结果内镜可清楚显示手术区歪曲结构,视野清晰,截骨更加精确和容易。所有求术者创伤小,无医源性意外创伤。术后随访1～12个月,鼻轮廓改善满意。结论内窥镜辅助歪鼻矫正术有助于获得良好的手术效果。     

Geography of the nose: A morphometric study

The noses of 34 attractive young North American Caucasian women were analyzed quantitatively, based on 19 nasal measurements (6 single and 7 paired linear measurements, 3 angles, and 3 inclinations) and 15 craniofacial measurements (10 linear measurements and 5 inclinations) taken directly from the face of the women. The relationship between the nasal measurements was studied in 16 proportion indices and the relationship between the nasal and the other craniofacial measurements in 13 interareal indices. The findings were also compared with those in 21 women with below-average faces. Two types of facial harmony disruption were identified:disharmony, a normal index with a visually apparent failure of proportionality, anddisproportion, an index value outside of the normal range. The percentage of disharmonies and disproportions was significantly higher in the group of 21 women with below-average faces. The study revealed a wide variety of ideal noses. Only a small portion of the measurements (12%) and proportion indices (7%) were at the mean value. At least two-thirds of the interareal proportion indices were located in the mean ±1 standard deviation portion of the normal range. Only about one-fifth of the interareal indices were disharmonious and 2.8% disproportionate. The disproportions were more areal in the attractive faces and more interareal in the below-average faces. The greatest disproportion in the attractive face was the moderately short columella in relation to the tip protrusion and in the below-average face the long nasal bridge related to the upper-lip height. Disproportions were associated with combinations of normal and abnormal measurements, or with two normal measurements of unequal quality, which resulted in a slightly smaller disfigurement. Analysis of ethnic and racial differences showed the soft nose as the main feature of the most characteristic differences. The study revealed that the key to restoration of facial harmony is the renewal of the uniformity of proportion index qualities by elimination disharmonies and/or disproportionate relationships.Presented in part to the VIIIth Congress of the International Society of Aesthetic Plastic Surgery, Madrid, September 17, 1985     

中国汉族青年女性鼻尖活动度的测量及临床意义

目的测量中国汉族青年女性的鼻尖活动范围,并与隆鼻术后的鼻尖活动范围对比,为鼻整形提供形态学资料及术后评判指标。方法选择100名普通汉族青年女性(正常组)和30名植入人工材料的隆鼻术后女性患者(隆鼻组),确定鼻的活动临界点A,测量鼻尖活动度、A点至鼻尖距离(A-P)和鼻长。结果正常组的鼻尖活动度经测量为35.73°±4.72°,隆鼻组鼻尖活动度为21.45°±7.53°,两者有明显统计学差异。正常组A-P间距为(16.62±1.95)mm,隆鼻组为(25.89±10.16)mm。鼻长均在正常范围内。隆鼻组63%的成员感觉鼻尖活动度下降,30%的成员因此对手术效果欠满意。结论证实植入人工材料的隆鼻术可降低鼻尖活动度,进而影响受术者对手术效果的评价。     

鼻表浅肌肉腱膜系统的解剖研究与临床应用

目的　探讨鼻表浅肌肉腱膜系统的存在及其临床意义。方法　对 3 0具成人尸体行大体解剖观察。结果　表浅脂肪层、肌肉腱膜层由肌肉层和包绕肌肉层表面的深浅两层腱膜组织构成。这样 ,鼻部肌肉和其表面的腱膜从解剖角度上可视为一个特定的结构单位 ,在此称之为鼻部表浅肌肉腱膜系统(NasalSMAS)。且发现鼻部表浅肌肉腱膜系统与面部表浅肌肉腱膜系统的相应结构层次移行。所以 ,又可认为鼻部表浅肌肉腱膜系统是面部表浅肌肉腱膜系统之一部分。其中的鼻部诸肌相互协调 ,共处在一个均衡的结构体系之中。表浅肌肉腱膜系统下方组织疏松 ,无重要血管神经走行是理想的剥离平面。结论　鼻表浅肌肉腱膜系统的完整对外鼻的形态维持具有重要意义 ,鼻部整形手术理想的剥离平面应位于鼻表浅肌肉腱膜系统的深面。     

The Central Role of the Nose in the Face and the Psyche: Review of the Nose and the Psyche

Background According to statistics released by the American Society of Plastic Surgeons in 2006, rhinoplasty is one of the most sought after aesthetic surgeries by ethnic patients and teenagers. It also is the most requested aesthetic operation by patients with body dysmorphic disorder. The psychosocial aspect of rhinoplasty is undeniable. Tagliacozzi in 1567 and Joseph more than a century ago were already aware of this aspect. Methods Using the terms “rhinoplasty,” “patients selection,” “psychological aspect,” and psychological outcome,” 30 studies were selected through searches of the MEDLINE, PUBMED, and EMBASE databases,. This review aimed to analyze how the most acknowledged experts of psychology, facial plastic surgery, and plastic surgery who have worked on the psychological outcome for rhinoplasty during the past century considered the nose–psyche relationship and the influence of rhinoplasty at the psychological level. Results The link between rhinoplasty, psychology, and social environment has been discussed by many important authors during the past century. All of them, independently of their field of study, have stressed that it is critical for surgeons to be aware of their responsibility regarding both the physical and emotional levels. There is evidence that an official preoperative interview is lacking. Conclusions To recognize the importance of rhinoplasty’s psychological implications, it is critical to make a good selection of patients seeking this operation and to have a good outcome. To this end, the preoperative interview is fundamental. Surgeons should be competent at both the psychological and surgical levels.     

Rhinoplasty. The Difficult Nasal Tip: Total Resection of the Alar Cartilages

There are many ways to reconstruct and make nasal tips more attractive. Sometimes we cannot find the best way unless we at least remove all surplus from the tip. This may occur in primary or secondary rhinoplasty. In principle, anything is possible when relocating and reconstructing. However, sometimes we face reality when we uncover the tip: broken or bulging cartilages that are difficult to put right. For this reason, in 1987 we thought of totally resectioning the alar cartilages in a case of secondary rhinoplasty with an unsightly appearance. After a year the result was seen to be correct from an aesthetic and a functional perspective and is still so today. Aesthetically, it kept its shape and did not collapse with nasal respiratory failure. We covered the end of the crus medialis with a small, temporary, one- to two-layered fascia patch. Except in exceptional cases, we now use this procedure: Total sectioning of the alar cartilages including the domes, or maintenance of them by preserving the fibroadipose tip tissue with a suture in the middle of the end of the crus medialis and by covering this with temporary fascia, which usually has two layers depending on the thickness of the skin of the tip. This procedure is indicated mainly in secondary rhinoplasty when the cartilages of the tip are completely destroyed, and in primary rhinoplasty when the tip is excessively wide and bulbous. Our philosophy is, therefore, elegance and beauty of the nasal tip with a solid and equilateral base without prejudices.     

鼻表浅肌肉腱膜系统在鼻成形术中的应用

目的　以鼻表浅肌肉腱膜系统为理论依据 ,进行鼻成形手术。方法　对本组 5 3 6例鼻成形手术患者假体置放层次进行回顾、比较和分析 ,并进而改为将假体放置在鼻表浅肌肉腱膜系统深面。结果　鼻模型假体放置在鼻表浅肌肉腱膜系统深面 ,成型更加自然、逼真 ,假体稳固 ,减少了并发症。结论　鼻成形手术理想的剥离平面应位于鼻表浅肌肉腱膜系统的深面 ,鼻SMAS对外鼻的形态学维持具有重要意义。     

下颌缘逆行岛状皮瓣在鼻再造术中的临床应用

目的　探讨下颌缘逆行岛状皮瓣移转在鼻缺损再造术中的临床应用。方法　设计以面动脉为蒂的逆行下颌缘岛状皮瓣移转行鼻再造术。结果　 2 0例皮瓣切取最大面积 7.0cm× 6 .5cm ,最小面积 6 .0cm× 4 .5cm。 2 0例鼻再造术皮瓣远端再造的鼻翼部发生局限性皮肤坏死 1例 ,经换药痊愈。再造的鼻小柱基底部裂开 1例 ,经Ⅱ期修复术后最终外形满意。其余病例全部Ⅰ期成功。经 3个月至 2年随访 ,再造鼻外形满意。结论　该手术方法行鼻再造是一种可供选择的新术式 ,具有较高的临床应用价值。     

手术治疗中青年女性外翻畸形

目的矫正中青年女性外翻畸形。方法经过解剖学研究，提出外翻形成的内在因素是一种“绞盘式”挤压机制。为消除这一机制，将收肌与趾的联系彻底切断，并与经第Ｉ跖骨头横孔穿行的囊筋膜瓣中１／３吻合，以起到坚强固定，直接牵拉第Ｉ跖骨头的作用。结果２０只足接受了本术式，１８只做了０．５～４年随诊，优良率１００％。结论收肌与囊筋膜瓣吻合，能有效地紧缩前足，达到兼顾美观及解除疼痛的目的。