自体肋软骨移植在延长鼻中隔和改善鼻尖鼻孔外形中的应用  

Application of autologous costal cartilage for nasal septum extension and nostril symmetry improvement in adults with cleft lip nasal deformity

作　　者：肖博 张曦 刘恒鑫 王娜 权鑫 魏思明 董琛 XIAO Bo;ZHANG Xi;LIU Heng-xin;WANG Na;QUAN Xin;WEI Si-ming;DONG Chen(Department of Plastic Surgery,Xijing Hospitalof Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学西京医院整形外科,陕西西安710032

出　　处：《中国美容整形外科杂志》2021年第9期517-520,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨自体肋软骨移植延长鼻中隔和改善鼻尖鼻孔外形矫治唇裂鼻畸形的临床效果。方法自2017年6月至2019年6月,空军军医大学西京医院整形外科收治了27例单侧唇裂鼻畸形患者,将切取的自体肋软骨制作成延长短小鼻中隔和支撑塌陷鼻翼的假体,采用开放式鼻整形手术方法,植入制作的假体以延长鼻中隔、支撑鼻翼,悬吊患侧鼻下外侧软骨在鼻中隔假体上,重塑鼻翼形状。测量手术前后鼻尖高度、鼻翼基底宽度、鼻孔高度和宽度、鼻唇角度及计算其比值。结果术后随访27例患者8~24个月,手术切口均一期愈合,无移植的软骨假体外露、术区感染等并发症发生,鼻部外形明显改善。与术前相比,术后鼻尖高度、鼻孔高度和宽度、鼻翼基底宽度、鼻唇角度的变化均具有统计学意义(P<0.05);手术前后各测量数据的比值也均具有统计学意义(P<0.05)。患者均较满意。结论自体肋软骨移植矫治单侧唇裂鼻畸形中鼻中隔短小、鼻翼塌陷其软骨假体可塑性较强,与鼻部软骨组织的软硬度较接近,改善效果较明显,是矫治唇裂鼻畸形较好的自体组织。Objective To explore the clinical efficacy of autologous costal cartilage for nasal septum extension and nostril symmetry improvement in adults with cleft lip nasal deformity.Methods From June 2017 to June 2019,27 patients with unilateral cleft lip nasal deformity were enrolled in Department of Plastic Surgery of Xijing Hospital of Air Force Medical University.The autologous costal cartilage was made into prosthesis to extend nasal septum and support nasal alar collapse in open rhinoplasty.The lower lateral cartilage of nose in affected side was suspended to the prosthesis of nasal septum to restore the shape of nasal alar.The nasal tip height,nostril heightand width,alar base width and nasolabial angle before and after operation were measured and the ratio was calculated.Results All patients were followed up for 8 to 24 months.All incisions were healing by first intention.No complications such as cartilage exposure or infection occurred.The appearance of nose was significantly improved.The postoperative changes in nasal tip height,nostril height and width,alar base width and nasolabial angle were statistically significant(P<0.05).The ratio of preoperative and postoperative measurement data was statistically significant(P<0.05).Patients were all satisfied with the results.Conclusion The autologous costal cartilage in the correction of short nasal septum and nasal alar collapse in unilateral cleft lip nasal deformity has obvious efficacy.The autologous costal cartilage is a good option for cleft lip nasal deformity.

关 键 词：唇裂鼻畸形 鼻整形术 自体肋软骨移植 鼻中隔短小 鼻翼塌陷 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]