Kaminskyi E. Clinical and morphological substantiation of the choice of the method of bone formation

Rhinoplasty is becoming an increasingly popular surgical procedure in both aesthetic and functional medicine. According to the International Society of Aesthetic Plastic Surgery (ISAPS), rhinoplasty ranks fourth among all aesthetic surgeries, following liposuction, breast augmentation, and blepharoplasty, accounting for 10% of all registered aesthetic procedures worldwide. The advent of advanced imaging techniques has revolutionized preoperative assessment and surgical planning in rhinoplasty. This dissertation study provides a detailed overview of current imaging techniques for the external nasal structures, including the nasal bones, lateral cartilages, septum, perpendicular plate of the ethmoid bone, and alar cartilages. The evolution of traditional imaging techniques, the integration of advanced software and artificial intelligence (AI), and their impact on surgical accuracy and clinical outcomes are discussed. Rhinoplasty is performed simultaneously with functional rhinological operations when indicated. To improve the respiratory function of the nose and normalize mucociliary clearance, in 50% of cases, it is necessary to change not only the shape and position of the cartilaginous and bony part of the nasal septum but also to shift and correct the nasal bones and upper and lower lateral cartilages. Incorrect work with the bone and cartilage structures of the external and internal nose impairs the respiratory function of the nose and the work of the mucous membrane, which can lead to impaired ventilation of the nasal sinuses. In 50% of cases, the main cause of nasal breathing complications during rhinoplasty is an incorrectly chosen method of forming the dorsum and nasal septum, as well as functional disorders of the nasal valves. The unresolved issues and the search for a reasonable choice of method for forming and strengthening the bony part of the dorsum of the nose in the complex of its structures during aesthetic rhinoplasty became the motivation for conducting this study. Given the above, it is of scientific interest to conduct further research for a wellfounded choice of a method for changing the shape of bone and cartilage structures while preserving or recreating their support and fixation functions. The subjects of the study were patients who planned to change the shape of the external nose or improve nasal breathing.