鼻部美学在歪鼻畸形伴鼻中隔偏曲患者外形重建及功能修复中的应用效果  

Application of nasal aesthetics in the appearance reconstruction and function repair for patients with deviated nasal deformity and nasal septum deviation

作　　者：王家玉[1] 曲滨[1] 奚凤[1] 李云川 WANG Jia-yu;QU Bin;XI Feng;LI Yun-chuan(Department of Otolaryngology,Harbin First Hospital,Harbin Heilongjiang 150010,China)

机构地区：[1]哈尔滨市第一医院耳鼻咽喉科,黑龙江哈尔滨150010

出　　处：《局解手术学杂志》2020年第12期988-991,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：哈尔滨市第一医院引进人才研究项目(2014SYYRCYJ05)。

摘　　要：目的探讨鼻部美学在歪鼻畸形伴鼻中隔偏曲患者外形重建及功能修复中的应用效果。方法选择于我院行鼻中隔成形术联合spreader软骨移植技术进行鼻中隔偏曲矫正的患者30例。按照Burm分类法实施分类,外伤性歪鼻患者采用个性化单侧截骨治疗,单侧唇裂歪鼻患者则予以特殊类型截骨治疗,同时联合鼻背与鼻部各亚单位移植修饰、肥大下鼻甲部分切除等技术进行歪鼻畸形的个性化综合治疗。部分单侧唇裂歪鼻畸形患者实施改良Tajima切口。术后对所有患者进行为期1年的随访,通过视觉模拟评分法(VAS)评估患者鼻外形满意度以及鼻通气功能,比较手术前后鼻歪斜最外侧点到面中线的垂直距离,分析术后1年并发症发生情况。结果术后鼻歪斜最外侧点到面中线垂直距离≥9 mm以及6~8 mm的患者占比低于术前,而≤2 mm的患者占比高于术前(P<0.05)。术后鼻外形满意度VAS评分为0~2分的患者占比低于术前,而6~10分的患者占比高于术前;术后鼻塞程度VAS评分为0~2分的患者占比高于术前,而6~10分的患者占比低于术前(P<0.05)。术后1年均未出现鼻腔粘连、鼻中隔穿孔、感染、血肿等并发症。结论鼻部美学应用于歪鼻畸形伴鼻中隔偏曲患者外形重建及功能修复效果显著,有利于提高鼻外形满意度,缓解鼻塞症状,且可有效预防并发症的发生。Objective To analyze the effect of nasal aesthetics in the appearance reconstruction and function repair for patients with deviated nasal deformity and nasal septum deviation.Methods A total of 30 patients who underwent nasal septoplasty combined with spreader cartilage graft were selected for nasal septum deviation correction in our hospital.According to the Burm classification system,patients with traumatic deviated nose were treated with personalized unilateral osteotomy;patients with unilateral cleft lip deviated nose were treated with special osteotomy.At the same time,individualized comprehensive treatment of deviated nose deformity was carried out by combining the transplantation modification of nasal dorsum and nasal subunits and partial resection of hypertrophic inferior turbinate.Patients with unilateral cleft lip deviated nose deformity were treated with modified Tajima incision.All the patients were followed up for one year after surgery.Visual analogue scale(VAS)was used to evaluate patients satisfaction of nasal appearance and ventilation function.The vertical distance between the most lateral point and midline of nasal skew before and after surgery were compared,and the occurrence of complications was analyzed one year after surgery.Results The proportion of patients with vertical distance between the most lateral point and midline of nasal skew more than 9 mm and 6 to 8 mm after the operation was lower than that before operation,while the proportion of patients with vertical distance less than or equal to 2 mm was higher than that before the operation(P<0.05).In terms of nasal appearance satisfaction,the proportion of patients with VAS score of 0 to 2 points was lower than that before surgery,while the proportion of patients with VAS score of 6 to 10 points was higher than that before surgery.In terms of ventilation function,the proportion of patients with VAS score of 0 to 2 points after the operation was higher than that before operation,while the proportion of patients with VAS score of 6 to 10

关 键 词：歪鼻畸形 鼻中隔偏曲 鼻部美学 重建外形 功能修复 整形美容 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]