1. incision
After routine disinfection and anesthesia, pay attention to two kinds of incisions: internal nasal incision and external nasal incision, each with its own advantages. External nasal approach adopts nasal columella u.
A-shaped incision extends to the anterior edge of alar cartilage on both sides, and then the subcutaneous tissue is separated upward. This incision has good exposure.
The incision of intranasal approach is on the upper edge of alar cartilage of bilateral nasal vestibule, cut into an arc, and passes through the front edge of septal cartilage, so that the two incisions are combined into one. After the incision is completed, the subcutaneous tissue can be widely separated upward, exposing the pear-shaped hole and the soft tissue inside the nose until it is above the nasal bone. At this time, we should pay attention to avoid operating the skin on the back of nose.
2. Treatment of cartilage cone
After nasal cartilage and bone scaffold are widely separated from nasal dorsal soft tissue, they can be cut from the northern edge of nasal septum epiphysis to separate nasal septum cartilage from nasal cartilage. Then the perioral flap of nasal septum mucosa on the wider side of nasal cavity is separated from the nasal septum cartilage to the nasal floor, and the soft inner front edge of nasal septum and its connection with the ethmoid bone and the vertical plate of pear bone are cut off, so that the nasal septum cartilage is in a semi-free state.
If necessary, a tension-reducing incision can be made on the cartilage of the nasal septum to completely move the nasal septum to the middle position. The nasal cartilage of patients with deviated nose is asymmetric, so the larger part of nasal cartilage outside the midline should be removed to correct the deviation of cartilage cone.
3. Treatment of osteoconus
According to the degree of vertebral body deviation, the frontal process and nasal bone of maxilla were cut from the edge of pear-shaped hole with bone chisel or bone saw and clamped with bone forceps.
The upper end of the nasal bone is twisted, and the bone cone can be loosened at this time. Push the nose with your fingers for plastic surgery. After observing that the nose shape is corrected satisfactorily, the incision can be closed.