自体肋软骨构建鼻尖三角形榫卯结构支架在鼻整形中的技术研究  

Technical Study of Nasal Tip Triangular Mortise and Tenon Joint Structure Framework Constructed with Autogenous Costal Cartilage in Rhinoplasty

作　　者：王荣锡 WANG Rong-xi(Cosmetic Surgery,Shanghai Huamei Medical Cosmetology Hospital,Shanghai City,200120,China)

机构地区：[1]上海华美医疗美容医院美容外科

出　　处：《中国医疗美容》2019年第11期19-22,共4页China Medical Cosmetology

摘　　要：目的探讨构建三角形榫卯结构肋软骨支架在鼻综合整形术中调整鼻尖形态的应用。方法2017年-2019年对61例患者均切取右侧第6肋或第7肋部分软骨,切成不同厚度的软骨条,构建三角形榫卯结构支架,按设计鼻尖突出度和旋转度调整软骨支架。游离下外侧软骨,缝合固定于肋软骨支架,恢复下外侧软骨解剖学形态,重塑理想鼻尖形态。雕刻膨体植入鼻背分离腔隙行鼻综合整形术。结果本组患者61例术后即刻均获满意效果。其中52例获随访6~12个月,鼻尖饱满,形态良好,鼻尖表现点明显,鼻背线条流畅,鼻气道通畅,鼻腔无异味,鼻小柱无偏斜,效果满意。结论用自体肋软骨按照三角形力学稳定原理构建榫卯结构支架调整鼻尖形态的手术方法,对于短鼻延长、抬高鼻尖、挛缩鼻修复、鼻整形失败患者再次鼻修复等均有确切的效果。Objective To discuss the application of constructed triangular mortise and tenon joint structure costal cartilage framework in comprehensive rhinoplasty for adjusting the contour of nasal tip.Methods In 2017~2019,the cartilages of the 6th or 7th costal region on the right side from 61 patients were cut into cartilaginous rays of different thicknesses to construct the triangular mortise and tenon joint structure,and the cartilage framework was adjusted based on the designed nasal tip protrusion and rotation.The free lower lateral cartilages were sutured and fixed at the costal cartilage framework to restore the anatomical shape of lower lateral cartilages and to reconstruct the ideal contour of nasal tip.The carved polytetrafluoroethylene was implanted to nasal dorsal separation cavity to perform comprehensive rhinoplasty.Results The 61 patients achieved post-operative immediate satisfactory effect.In the 6~12 months of follow-up,52 patients showed plump nasal tip,improved contour,obvious nasal tip defining point,smooth nasal dorsal line,and unobstructed nasal airway,free from extraneous odor in the nasal cavity,free from oblique in the nasal columella,with satisfactory effect.Conclusion The surgical method of constructing mortise and tenon joint structure framework with autogenous costal cartilage to adjust the contour of nasal tip based on the triangular mechanical stability principle has exact effect on short nose lengthening,nasal tip elevation,nasal contracture repair and re-nasal repair for patients with failure in rhinoplasty.

关 键 词：自体肋软骨 榫卯结构 三角支架 鼻整形修复 短鼻延长 挛缩鼻 

分 类 号：R76[医药卫生—耳鼻咽喉科]