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Techniken zur Rekonstruktion der Keystone Area

Techniques to reconstruct the keystone area

  • Leitthema
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Journal für Ästhetische Chirurgie Aims and scope

Zusammenfassung

Hintergrund

Die stabile Fixierung des Neoseptums und der Dreiecksknorpel am Os nasale mittels Naht ist ein essenzieller Schritt bei der Durchführung einer extrakorporalen Septumkorrektur. Nur durch die sichere Rekonstruktion dieser anatomisch wichtigen Struktur können Unregelmäßigkeiten des Nasenrückens mit Einsattelung oder Inverted-V-Deformierungen verhindert werden. Eine weitere wichtige Indikation ist die Vermeidung einer Verbreiterung des Nasenrückens durch Auseinanderweichen der osteotomierten Nasenbeine.

Zielsetzung

Es erfolgt die Vermittlung der Methodik verschiedener Nahttechniken zur Rekonstruktion der Keystone Area.

Schlussfolgerung

Die Criss-cross-Technik, die TTC-suture („transcutaneous transosseous cerclage suture“)-Technik sowie die mTTC-suture („modified transcutaneous transosseous cerclage suture“)-Technik sind verlässliche und einfache Techniken zur Erzielung eines reproduzierbaren ästhetischen und funktionellen Ergebnisses.

Abstract

Background

Securing a stabile fixation of the upper lateral cartilage, the nasal bone and the septum with a suture is a crucial step when performing extracorporeal septoplasty. Irregularities of the nasal bridge with saddle formation or inverted-V deformation can only be prevented by a secure reconstruction of this anatomically important structure. A further important indication is avoidance of widening of the nasal bridge by dehiscence of the nasal bone after osteotomy.

Objective

This review highlights the different suture techniques for keystone reconstruction and fixation of the septum to the nasal bone and stabilization of the narrowed nasal pyramid.

Conclusion

The criss-cross technique as well as the transcutaneous transosseous cerclage (TTC) suture and modified transcutaneous transosseous cerclage (mTTC) suture are reliable and simple techniques, which achieve reproducible and aesthetically pleasing results.

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Authors and Affiliations

  1. Marienhospital Stuttgart, Böheimstr. 37, 70199, Stuttgart, Deutschland

    M. Brandstetter, S. Mann, W. Gubisch & S. Haack

Authors
  1. M. Brandstetter
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  2. S. Mann
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  3. W. Gubisch
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  4. S. Haack
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Corresponding author

Correspondence to M. Brandstetter.

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Interessenkonflikt

M. Brandstetter, S. Mann, W. Gubisch und S. Haack geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben.

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Video 1 Video Criss-cross-suture-Technik

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Brandstetter, M., Mann, S., Gubisch, W. et al. Techniken zur Rekonstruktion der Keystone Area. J Ästhet Chir 10, 21–25 (2017). https://doi.org/10.1007/s12631-016-0071-2

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  • DOI: https://doi.org/10.1007/s12631-016-0071-2

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