软骨性斜形歪鼻矫正术  

Correction of cartilaginous oblique deviated noses

作　　者：肖芃[1] 孙家明[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院整形外科,湖北武汉430022

出　　处：《中国美容整形外科杂志》2010年第12期708-710,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 总结继发性软骨性斜形歪鼻的治疗经验,探讨行之有效的手术方式,提高临床治疗效果.方法 采用开放式入路,完全显露鼻中隔软骨的前缘和下缘,在一侧的黏软骨膜下剥离鼻中隔软骨,切断其与筛骨垂直板和犁骨的连接,并过度矫正固定其下缘于前鼻棘上,使鼻中隔复位到面正中线上,偏曲明显者予以适当切除中隔软骨,必要时行软骨扩展移植,重塑鼻支架,双侧鼻腔内碘仿纱条填塞同定.本组患者共45例,外伤后畸形者26例,唇裂术后继发畸形者19例.结果 45例患者术后均Ⅰ期愈合.所有患者术后获随访6～12个月,鼻外形均恢复良好,未出现并发症.结论 鼻中隔联合整复术矫正继发性软骨性斜形歪鼻是一种行之有效的手术方法.Objective To summarize the experiences of treating secondary, cartilaginous oblique deviated noses and explore an effective technique to improve the clinical efficacy. Methods Through the open approach, the anterior and inferior margin of quadrangular cartilage was exposed completely and quadrangular cartilage was dissected under the unilateral mucoperiosteum, and its connection to perpendicular layer of ethmoid bone and vomer bone was cut, then its overeorreet inferior margin was fixed to anterior nasal spine to resetting the nasal septum to the facial midline. For the patients with obvious deviation, it was necessary to cut part of quadrangular cartilage properly or perform the expanded cartilage transplantation, and reshape the nose stretcher filling the nasal cavities with iodoform gauze. Forty-five patients, including 26 cases of posttraumatic deformities and 19 cases of nasal deformities ＇after cheiloplasty were performed the operation mentioned-above. Results Forty-five cases healed primarily. They were all satisfied with well nasal shape and few complications after 6 - 12 months follow-up. Conclusion Combined corrections of quadrangular cartilage for secondary cartilaginous oblique deviated noses can obtain a satisfactory result.

关 键 词：软骨性斜形歪鼻 鼻中隔软骨 矫正术 

分 类 号：R622[医药卫生—整形外科]