双侧耳甲艇软骨构建鼻尖软骨支架复合体在鼻综合整形中的应用  

The application of bilateral auricular concha cartilage graft in the construction of nasal tip cartilage complex in comprehensive rhinoplasty

作　　者：彭炜锋 欧昕宇 赵海福 方柏荣[1] 王先成[1] Peng Weifeng;Ou Xinyu;Zhao Haifu;Fang Bairong;Wang Xiancheng(Department of Burn and Plastic Surgery,the Second Xiangya Hospital,Central South University,Changsha 410011,China;Health Medical Cosmetic Hospital,Changsha 410007,China)

机构地区：[1]中南大学湘雅二医院烧伤整形美容外科,长沙410011 [2]长沙禾丽美容医院,410007

出　　处：《中华整形外科杂志》2020年第8期899-904,共6页Chinese Journal of Plastic Surgery

摘　　要：目的:探讨双侧自体耳甲艇软骨移植构建鼻尖软骨支架复合体在综合鼻整形中的应用效果。方法:对2016年1月至2019年6月中南大学湘雅二医院及长沙禾丽医疗美容医院收治的521例鞍鼻患者的临床资料进行回顾性分析,其中男12例,女509例,年龄18~53岁,初次鼻整形患者310例,二次鼻修复患者211例,排除组织破坏严重的挛缩鼻患者。切取双侧耳甲艇软骨,将其进行切割、组合,包括鼻小柱支撑移植物、抑后旋移植物以及帽状移植物,并构建鼻尖支架复合体,塑造鼻尖形态,同时将硅胶假体或膨体聚四氟乙烯雕刻成柳叶形,抬高鼻梁。术后对患者进行随访,分别让医生、患者和第三方对比术前和术后6个月以上照片来进行手术效果的评估,三方都满意为显著有效,两方满意为有效,一方满意为一般,都不满意为差;术后若出现感染、假体外露等并发症判为差。同时对鼻尖高度变化及鼻长度的变化进行测量。结果:521例患者术后即刻均获得满意的外形,随访6~24个月,鼻尖外形保持良好,血液循环、色泽正常,鼻尖表现点明显,自然美观、立体挺拔。521例中显著有效471例,有效30例,效果一般15例,差5例,疗效满意度为96%(501/521)。鼻尖高度比术前抬高(3.5±0.3) mm,鼻长度比术前延长(4.9±0.4) mm。结论:以双侧耳甲艇软骨构建鼻尖软骨支架复合体联合硅胶假体或膨体行综合鼻整形,可作为鞍鼻患者初次鼻整形及二次修复鼻整形的常规方法,效果可靠。Objective To explore the application of bilateral autogenous auricular concha cartilage graft in the construction of nasal tip cartilage complex in comprehensive rhinoplasty.Methods From January 2016 to June 2019,a total of 521 rhinoplasty patients in the Second Xiangya Hospital and in the Health Medical Cosmetic Hospital received the operation,including 310 patients with primary rhinoplasty and 211 patients with secondary rhinoplasty.There were 12 males and 509 females,aged 18-53 years.Contracted nose patients with severe tissue destruction were excluded.The operation method:the bilateral auricular concha cartilage was cut and combined,including the nasal columella support graft,the anti derotation graft and the cap graft,and the combination of the nasal tip framework complex was constructed to shape the nasal tip framework.At the same time,the expanded polytetrafluoroethylene or silicone prosthesis was carved into willow leaf shape to elevate the bridge of the nose.Patients were followed up after operation.Physicians,patients and a third party were asked to evaluate the preoperative and postoperative photos of more than 6 months to evaluate the surgical effect.The results suggested that the three parties were regarded as significantly effective,two parties satisfied as effective,one party satisfied as average,all dissatisfied as poor;postoperative complications such as infection and prosthesis exposure were judged as invalid.At the same time,the changes of nose tip height and nose length were measured.Results 521 patients in this group got satisfactory appearance effect immediately after operation.After 6-24 months follow-up,the shape of the nose tip remained good,the color of blood circulation was normal,the appearance of the nose tip was natural and beautiful,three-dimensional and straight.Among the 521 cases,471 cases were significantly improved,30 cases were improved,15 cases were acceptable and other 5 cases were poor.The satisfaction rate was 96%(501/521).The average height of nasal tip was(3.5±0.3)mm hi

关 键 词：耳软骨 支架 鼻成形术 鞍鼻 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]