颗粒软骨在唇裂术后鼻畸形中的应用  

The application of diced cartilage in postoperative nasal deformity of cleft lip surgery

作　　者：梁瑛 王先成[1] 孙扬 熊祥[1] 孟宪熙 曾芳琳 杨远明 常劲远 胡一鸣 江从航 李晓芳[1] 方柏荣[1] Liang Ying;Wang Xiancheng;Sun Yang;Xiong Xiang;Meng Xianxi;Zeng Fanglin;Yang Yuanming;Chang Jinyuan;Hu Yiming;Jiang Conghang;Li Xiaofang;Fang Borong(Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院烧伤整形外科,长沙410011

出　　处：《中华整形外科杂志》2020年第1期49-52,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨应用颗粒软骨纠正唇裂术后鼻畸形患者鼻翼基底过低的临床效果。方法回顾性分析2018年1月到2019年1月中南大学湘雅二医院收治的15例唇裂术后鼻畸形患者病历资料。男6例,女9例,年龄16~24岁,平均19岁,皆为单侧唇裂矫正术后并发鼻畸形患者。均取自体肋软骨重建鼻部轮廓,将剩余的自体肋软骨切割成0.5~1.0 mm的颗粒,最后通过切掉前端针乳头的1 ml注射器填充到预先剥离出来的梭形鼻翼基底腔隙内,注射量0.8~1.0 ml。于手术前、后拍摄患者面部照片效果,用Adobe Photoshop CS 6软件进行分析。调查患者满意度及并发症情况。结果本组15例,术后鼻翼基底皆明显抬高,鼻畸形轮廓得到较大改善,无明显并发症。术后随访6~15个月,平均10个月,鼻部形态稳定,软骨颗粒未见明显吸收。Adobe Photoshop CS6软件分析结果提示鼻基底抬高,患者对整体效果均满意。结论应用颗粒软骨纠正唇裂术后鼻畸形患者的鼻翼基底凹陷具有可行性,可充分利用剩余的自体肋软骨,减少供、受区损伤,临床效果较好。Objective To investigate the clinical effect of diced cartilage in correcting nasal alar base depression after cleft lip surgery.Methods A retrospective study was conducted in 15 patients of nasal deformity after lip surgery from January 2018 to January 2019.All the patients were taken from autologous costal cartilage to reconstruct the outline of nasal malformation,and the remaining autologous costal cartilage was cut into 0.5-1.0 mm pieces and filled into the basilar lacunar space of the nasal alar by the 1 ml syringe whose anterior needle nipples was removed.The effects of visual images before and after operation were compared and analyzed by Adobe Photoshop CS6 software.The patients were followed up for 6-15 months(mean 10months).The satisfaction and complications of the patients were investigated.Results The nasal alar base was significantly elevated and the outline of the nasal deformity was improved in 15 patients after operation.The overall effect was satisfactory and no obvious complications were found.No obvious absorption was found in the follow-up.Conclusions The application of diced cartilage to correct the nasal alar base depression after cleft lip surgery was a feasible method with important clinical value.It advanced in taking good use of the remaining cartilage and reducing the damage to both the donor and recipient area.

关 键 词：鼻 畸形 软骨 颗粒 鼻翼基底 

分 类 号：R76[医药卫生—耳鼻咽喉科]