改良外切法鼻翼缩小术的临床应用  

Clinical application of modified alar reduction with external incision

作　　者：甘沛冬 阳水发 易阳艳[1] 杨娟敏 王朝慧[1] 吴舒[1] Gan Peidong;Yang Shuifa;Yi Yangyan;Yang Juanmin;Wang Zhaohui;Wu Shu(Department of Plastic Surgery,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院整形外科,330006

出　　处：《中华整形外科杂志》2020年第9期1034-1038,共5页Chinese Journal of Plastic Surgery

摘　　要：目的探讨改良外切法鼻翼缩小术矫正鼻翼肥大的效果。方法选取2017年1月到2019年1月于南昌大学第二附属医院整形外科就诊的16例鼻翼肥大患者,男1例,女15例,年龄21~39岁。均采用改良外切法鼻翼缩小术,术中将鼻翼小叶外缘切口延长到鼻前庭面,并切除部分鼻翼小叶前庭组织,对鼻翼断端朝鼻孔方向旋转内移,使得鼻翼附着点向内、向上移位,重新定位鼻翼附着点,矫正鼻翼肥大和鼻基底过宽。采集患者术前、术后1个月、6个月正位、侧位、鼻基底位照片,测量内眦间距离(ICD)、鼻翼间距离(IW)及鼻基底间距离(BW),计算术前、术后1个月、6个月时IW、BW与ICD的比值,及术后1个月、6个月时IW和BW的缩窄率。采用温哥华瘢痕VSS量表进行瘢痕评估。符合正态分布的变量使用配对t检验进行组间比较,不符合正态分布的变量使用Wilcoxon秩和检验进行分析,P<0.05为差异具有统计学意义。结果本组16例,均随访6~12个月,平均8个月。16例患者IW/ICD术前为1.160±0.080,术后1个月为1.049±0.047,较术前缩小0.110±0.049,6个月为1.038±0.047,较术前缩小0.120±0.049,术后与术前比较差异均具有统计学意义(P<0.05),IW缩窄率术后1个月为9.3%,术后6个月为10.2%。BW/ICD术前为1.035±0.047,术后1个月为0.960±0.039,较术前缩小0.072±0.019,术后6个月为0.950±0.034,较术前缩小0.079±0.020,术后与术前比较差异均具有统计学意义(P<0.05),BW缩窄率术后1个月为7.0%,术后6个月为7.6%。温哥华瘢痕VSS量表评分,术后1个月为3(2.25,3)分,术后3个月为1(0.25,1)分,术后6个月为1(0,1)1分,术后3个月与术后1个月时比较,差异具有统计学意义(Z=-3.472,P=0.001),术后6个月与术后3个月时比较,差异无统计学意义(Z=-1.414,P=0.157)。所有患者术后均无切口感染、鼻翼不对称、术后鼻腔通气阻塞等明显并发症,术后鼻翼肥大和鼻基底过宽得到明显改善,术后瘢痕不明显。患者�Objective To investigate the effect of modified alar reduction with external incision to correct alar hypertrophy.Methods From January 2017 to January 2019,16 patients 1 male and 15 females,aged 21 to 39 with alar hypertrophy were treated in the plastic surgery department of the Second Affiliated Hospital of Nanchang University.Modified alar reduction with external incision were applied.In order to rotate the free alar lobules,the incision was extended in nasal lobules to the vestibular floor and remove part of the vestibular tissue of the alar lobules during the operation.Then the free alar was moved into the nostril to make the alar junction shift inward and upward,and reposition the alar junction to correct the alar hypertrophy and the wide nasal base.Photos of patients in frontal,side,and basal view before operation,1 month,6 months after operation.Intercanthal distance(ICD)、interinter-alar width(IW)、nasal base width(BW)were measured.The ratios of IW,BW and ICD before operation,1 month,and 6 months after operation,and the narrowing rate of IW and BW at 1 month and 6 months after operation were summarized.The incision scar was evaluated with reference to the Vancouver Scar Scale.Normally distributed variables were compared using an paired t test.Nonparametric continuous variables were compared using Wilcoxon rank sum test.When P<0.05,the difference is considered statistically significant.Results Sixteen patients were followed up for 6 to 12 months,averaged of 8 months.The IW/ICD of 16 patients at preoperation,after operation 1 month and 6 months were 1.160±0.080,1.049±0.047(0.110±0.049 decrease than before operation)and 1.038±0.047(0.120±0.049 decrease than before operation).The differences were statistically significant(P<0.05).The IW constriction rates were 9.3%at 1 month after operation and 10.2%at 6 months after operation.BW/ICD at preoperation,after operation 1 month and 6 months were 1.035±0.047,0.960±0.039(0.072±0.019 smaller than preoperation),and 0.950±0.034(0.079±0.020 smaller than preo

关 键 词：鼻 正畸学 矫正 鼻翼肥大 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]