肋硬骨-软骨联合隆鼻修复创伤后鼻畸形  

Rib osseocartilaginous graft in posttraumatic rhinoplasty

作　　者：高嘉蔓 徐梁[1] 姜陶然[1] 俞哲元[1] 曹德君[1] GAO Jiaman;XU Liang;JIANG Taoran;YU Zheyuan;CAO Dejun(Department of Plastic and Reconstruction Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,上海市200011

出　　处：《组织工程与重建外科》2021年第3期227-230,共4页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨利用肋硬骨-软骨移植重建鼻部支撑支架修复创伤鼻畸形的效果。方法2016年1月至2018年1月,共16例患者因重度外伤后鼻畸形,行肋硬骨-软骨联合隆鼻术。手术前后均完善相关检查,拍摄标准照片并行头颅三维CT扫描。通过头颅三维CT重建测量患者手术前后的鼻翼宽度、鼻背长度、鼻小柱高度以及鼻软组织三角的角度;评价术后鼻部通气效果、鼻外形满意度;记录不良反应发生情况。全部患者术后随访12~24个月。结果患者术后1年,鼻底宽度及鼻小柱高度较术前有了明显改善(P<0.05);鼻背长度及鼻软组织三角的角度与术前相比无明显改变(P>0.05)。所有患者术后均获得了较为满意的鼻部外形效果,并改善了通气功能。胸部肋骨供区无明显并发症,鼻部移植物无明显弯曲、吸收,无二次手术修复者。结论肋硬骨-软骨联合隆鼻修复创伤鼻畸形具有较高的临床应用价值,可显著改善患者鼻部通气功能并塑造良好外形,减少并发症,是一种安全、有效的创伤鼻畸形修复方法。Objective To evaluate the effect of reconstruction of nasal supporting framework with rib osseocartilaginous graft to repair posttraumatic nasal deformity.Methods From January 2016 to January 2018,16 patients who underwent rib osseocartilaginous graft augmentation rhinoplasty were collected.Before and after the operation,photos and three-dimensional CT scan of the head were taken,and follow-up records were made for 12-24 months.The width of nasal base,length of nasal dorsum,height of nasal columella and angle of nasal soft tissue triangle were measured by 3D cranial CT reconstruction.The effects of postoperative nasal ventilation and the satisfaction of nasal appearance were evaluated.The occurrence of adverse reactions was recorded.Results One year after operation,the width of nasal base and height of nasal columella were significantly improved(P<0.05),the length of nasal dorsum and angle of nasal soft tissue triangle were not significantly changed(P>0.05).All patients were satisfied with the result,and the ventilation function was significantly improved.There were no obvious complications in the rib supply area of the chest,no obvious bending and absorption of the nasal grafts,and no secondary repair.Conclusion Reconstruct posttraumatic nasal deformity with rib osseocartilaginous graft has a high clinical application value,which can significantly improve the nasal ventilation function,create a good shape,and reduce the complications.It is a safe and effective method to repair severe posttraumatic nasal deformity.

关 键 词：创伤鼻畸形整复 肋硬骨-软骨移植物 隆鼻术 

分 类 号：R622[医药卫生—整形外科]