单侧唇腭裂伴发鼻畸形个体化治疗重建鼻软骨支架结构31例  

Individualized therapy for the secondary nasal deformity of unilateral cheilopalatognathus and nasal cartilage reconstruction in 31 cases

作　　者：王绍义[1] 蒋欣泉[1] 张志愿[1] 张秀丽[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颌面外科,上海市200011

出　　处：《中国组织工程研究与临床康复》2008年第2期356-359,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：上海市科学技术委员会科研基金(05DJ14006);上海市重点学科建设项目(Y0203)~~

摘　　要：目的:唇裂术后鼻畸形的整复相对更为复杂,由于鼻畸形与唇畸形多同时存在,而且相互影响,因此制定行之有效、个体化的手术治疗方案已成为当前研究的重点,引入构建组织工程化骨修复单侧唇腭裂继发鼻畸形,并探讨手术设计方式的可行性和合理性。方法:①对象:选择2001-03/2005-09本院收治的单侧完全性唇腭裂并均已行唇腭裂修补术患者31例,年龄15～41岁,平均24岁。患者对所进行的治疗均知情同意。②方法:采用改良Millard联合经鼻小柱开放术式、个体化矫正畸形鼻软骨支架结构。③评估:患者手术效果、材料不良反应。结果:31例患者全部进入结果分析。①31例患者切口全部一期愈合。②术后鼻基底抬高,鼻尖耸立,鼻孔及鼻翼外形两侧基本对称,偏斜的鼻小柱、鼻底畸形亦得以纠正。③随访2至3年,未见畸形复发,无宿主与材料不良反应。结论:采用联合式、个体化的手术方式,能有效地矫正单侧唇腭裂继发的鼻畸形,并能够有效的重建鼻软骨支架结构。AIM： The restitution of nasal deformities after cheiloplasty is very complex. As nasal deformity always co-exists with lip deformity, and there is interaction between them, it is necessary to formulate effective and individualized operative strategy. In this study, the tissue-engineered bone was employed to correct secondary nasal deformity of unilateral cheilopalatognathus, and the feasibility and rationality of operation was explored. METHODS： （1）Thirty-one cases of unilateral cheilopalatognathus, who had been proceeded cheiloplasty in Ninth People＇s Hospital, were selected. They aged ranging from 15 to 41 years （mean, 24 years） and agreed to the treatment. （2）Using improved Millard technique combined with open rhinoplasty with transcolumellar incision to correct the framework of nasal cartilage. （3）The operation results and material complications were evaluated. RESULTS： All 31cases were involved in the result analysis. （1）The incision of all patients was primarily healed. （2）After operation, the nasal base and nasal tip were elevated, and nostril and nasal wing were basically symmetric. The deflected collumella nasi and deformed basis nasi were corrected. （3）After the follow up for 2 to 3 years postoperatively, the result was satisfactory. No deformity relapse was found, either host or material adverse effects. CONCLUSION： The individualized operation may effectively correct the nasal deformity after the unilateral cheilopalatognathus, and reconstruct the framework of nasal cartilage.

关 键 词：唇裂 腭裂 鼻畸形 整复 

分 类 号：R318[医药卫生—生物医学工程]