Crooked nose correction
The nose is a nasal deformity caused by trauma or nasal cartilage and bone tissue dysplasia. According to the location of the distortion, the clinical two can be divided into the following two types, which can be corrected by surgery. The cartilage is distorted in the cartilage below the nasal bone, mainly in the lower part of the nose and the tip of the nose. The distortion of the bone is mostly in the upper part of the bridge of the nose and at the base of the nose, which is caused by the asymmetry of the bone tissue. The above two types can sometimes exist at the same time, that is, the entire outer nose, the nasal roots and the tip of the nose are distorted. Treatment of diseases: nasal trauma, nasal septum deviation Indication The nose is a nasal deformity caused by trauma or nasal cartilage and bone tissue dysplasia. According to the location of the distortion, the clinical two can be divided into the following two types, which can be corrected by surgery. 1. The cartilage is distorted: the cartilage below the nasal bone, mainly in the lower part of the nose and the tip of the nose. 2. Bone distortion: The distortion is mostly in the upper part of the bridge of the nose and the root of the nose, which is caused by the asymmetry of the bone tissue. The above two types can sometimes exist at the same time, that is, the entire outer nose, the nasal roots and the tip of the nose are distorted. Preoperative preparation 1. Take a photo of the face in front of the surgery. 2. Shave the beard and cut off the nose hair. Surgical procedure (a) cartilage correction 1. Position: Take 20° supine and disinfect the skin. 2. The incision is made in an arc-shaped incision on the nasal vestibule and the alar cartilage on both sides of the nasal cavity, and then a two-blade knife is inserted from the front of the nasal cartilage to separate the soft tissue and the nasal frame at the nasal back to the nasal bone. At this time, be careful not to damage the skin on the nose and back. 3. Cut the septum front end and insert the incision of the blunt septum from the left nasal vestibule into the contralateral vestibular incision, and cut the septum along the leading edge of the septal cartilage until the free edge of the front end, then fold down. Cut the septum along the free edge. 4. Excision of excessive nasal cartilage with a stripper or a small scissors to separate the soft tissue of the septal cartilage and the nasal cartilage adhesion. After seeing clearly, the nasal cartilage and the septal cartilage on the hemiplegic side are first cut and separated. Then, the contralateral nasal cartilage and the septal cartilage are separated, and as appropriate, the excessive nasal cartilage is cut off, so that the sides are approximately symmetrical. At this time, if the leading edge of the septal cartilage is deformed and fat, it can be appropriately removed. 5. Peeling the septal mucosa from the septum cut into the stripper, separating the mucosa on one side from the subchondral and septal cartilage, and starting with a sharp stripper is easier to replace, then change the blunt, so as not to Mucosal peeling. The extent of the stripping can be determined in accordance with the wide range of distortions, as is the case with general submucosal correction. 6. The posterior margin of free septal cartilage at this time the upper edge of the septal cartilage, the leading edge and one side have been separated from the surrounding tissue, and the cartilage can be cut at the posterior border of the vertical plate of the ethmoid, and sometimes a narrow one should be removed. Cartilage, so that there is enough space for resetting, so as not to cause overlap. When cutting the cartilage, avoid cutting through the contralateral mucosa to avoid adverse consequences. 7. The base of the septal cartilage of the basement of the septal cartilage is attached to the vomer bone. A narrower septum can be used to chisel the septal cartilage and the vomer, which may be encountered. More bleeding, can be stopped with adrenaline gauze. At this time, the septal cartilage is separated from the surrounding tissue on the four sides and one side except for the contralateral and septal mucosa junctions. According to the situation of distortion, the reset is reset to the center and fixed. 8. Correction of the remaining part of the septal distortion such as the vertical plate of the ethmoid and the vomer section are still deformed such as distortion or condyle, the deformed bone tissue may be partially removed or properly corrected as needed. 9. Suture incision: the incision at the nasal vestibule and the anterior septum should be well aligned and then sutured with silk thread. 10. The external nasal fixation is blocked in the nasal cavity, and the septal cartilage is fixed in the median position to achieve hemostasis. After the external nasal surgery, the model was applied with a proofing gel and fixed under pressure. (B) bone distortion correction bone distortion is more complex, there are uplifts, depressions, distortions and other conditions. Now, only the nasal distortion caused by the collapse of the nasal bone caused by the nasal injury is not corrected in time, and the correction method is introduced below. Distortion of other different conditions can be corrected for different lesions. 1. Location: semi-recumbent position and disinfection of the skin. 2. The incision is made into an arc-shaped incision on the concave side nasal vestibule and the alar cartilage. From here, a small scissors or a two-blade knife is inserted to separate the soft tissue on the nasal bone. 3. Saw the collapsed nose bone with a nose saw to saw the sides of the collapsed nose so that it can move freely. This step can also be done with a nose chisel. 4. Nasal reduction: Use the forceps to lift the nasal bones that have been broken in the nasal cavity, and fill the nasal cavity with iodoform gauze so that it does not collapse. 5. External fixation: The model is made of proofing glue and fixed outside the nose.
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