第6自体肋软骨在外伤后重度鞍鼻畸形修复中的临床应用  

Clinical application of the 6th autogenous costal cartilage in the treatment of severe saddle nose deformity after trauma

作　　者：谭骛远[1] 雷少榕[1] 范鹏举[1] 龙剑虹[1] TANWuyuan;LEI Shaorong;FAN Pengju;LONG Jianhong(Department of Plastic and Cosmetic Surgery,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院整形美容科,长沙410008

出　　处：《中南大学学报（医学版）》2020年第8期954-959,共6页Journal of Central South University ：Medical Science

摘　　要：目的:鞍鼻畸形是临床常见的鼻部畸形,本研究探讨应用第6自体肋软骨矫治外伤后重度鞍鼻畸形的可行性。方法:回顾性分析2016年3月至2019年3月收治的外伤后重度鞍鼻畸形患者15例,采用第6自体肋软骨重建鼻尖、鼻背,随访6至13个月,观察鼻部外形改善情况,并比较鼻背凹陷度、鼻唇角、鼻背长度、鼻背角的变化。结果:14例患者对术后效果基本满意,1例术后出现感染,经积极治疗控制感染2个月后行再次鼻整形手术。术后即刻鼻背凹陷度[(1.19±0.94)mm]、鼻唇角[(94.06±1.52)°]较术前[分别(8.28±0.24)mm,(109.42±2.78)°]减小(均P<0.05),鼻背长度[(44.18±1.02)mm]、鼻背角[(132.84±2.33)°]较术前[分别(31.73±1.86)mm,(122.87±2.42)°]增加(均P<0.05);术后随访与术后即刻鼻背凹陷度、鼻唇角、鼻背长度、鼻背角相比差异均无统计学意义(均P>0.05)。结论:采用第6自体肋软骨修复外伤后重度鞍鼻畸形是行之有效的治疗办法。Objective:Saddle nose deformity is a common clinical nose deformity.This study aimed to evaluate the effectiveness of the 6th autogenous costal cartilage in the treatment of severe saddle nose deformity after trauma.Methods:A retrospective analysis was conducted on 15 patients with severe post-traumatic saddle nose deformity from March,2016 to March,2019.The nasal tip and dorsum were reconstructed with autogenous costal cartilage.All patients were followed up for 6 to 13 months and changes in nasal appearance were evaluated.The changes in dorsum sag,nasolabial angle,nasal dorsal angle,and dorsum length were measured.Results:Fourteen patients were basically satisfied with post-operative outcome.Only one patient developed infection afterwards,which was improved by the revised rhinoplasty 2 months after active treatment.The immediate nasal dorsal depression[(1.19±0.94)mm]and nasolabial angle[(94.06±1.52)°]after operation decreased compared with those before surgery[(8.28±0.24)mm,(109.42±2.78)°,respectively;all P<0.05].The immediate nasal dorsal length[(44.18±1.02)mm]and nasal dorsal angle[(132.84±2.33)°]increased compared with those before operation[(31.73±1.86)mm,(122.87±2.42)°,respectively;all P<0.05].The data at follow-ups showed no statistical difference compared with the immediate data after operation.Conclusion:Rhinoplasty with the 6th autogenous costal cartilage is an effective method for the correction of severe saddle nose deformity after trauma.

关 键 词：鞍鼻畸形 自体肋软骨 重建 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]