鼻整形术中耳前及耳后入路切取耳软骨的比较研究  

Anterior and posterior auricular approach for ear cartilage harvesting rhinoplasty:a comparative study

作　　者：龙飞[1] 杨伊兰 秦锋 李云竹 张文超 张明子[1] 夏泽楠 王晓军[1] 刘志飞[1] Long Fei;Yang Yilan;Qin Feng;Li Yunzhu;Zhang Wenchao;Zhang Mingzi;Xia Zenan;Wang Xiaojun;Liu Zhifei(Department of Plastic Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院整形美容外科,北京100730

出　　处：《中华医学美学美容杂志》2022年第1期18-21,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的:比较鼻整形术中耳前及耳后入路切取耳软骨的优劣。方法:2017年1月至2018年12月,在北京协和医院整形外科行耳软骨综合鼻整形术患者63例,男3例,女60例;年龄18~43岁,平均31.6岁。分为耳前入路组32例(64侧)和耳后入路组31例(62侧),比较两组手术时间、手术并发症、术后瘢痕外观。结果:耳前入路组切取耳软骨平均用时(12.6±1.1)min,短于耳后入路组平均用时(20.8±1.7)min(P<0.01)。耳前入路组患者并发症发生3侧,占4.8%,耳后入路组并发症发生10侧,占15.6%。两组患者术后伤口均愈合良好,平均随访13个月,两种方法术后瘢痕无明显区别。结论:耳前入路切取耳软骨操作方便、手术用时短、并发症少、瘢痕不明显;耳前入路较耳后入路更有优势,值得临床应用。Objective To compare the pros and cons of harvesting ear cartilage through anterior and posterior auricular approaches during rhinoplasty.Methods From January 2017 to December 2018,63 patients with otochondral rhinoplasty in our hospital were enrolled in this study,60 were female and 3 were male;the average age was 31.6 years(range,18 to 43).They were randomly divided into anterior auricular approach group with 32 cases(64 sides)and posterior auricular approach group with 31 cases(62 sides).Surgical duration,complications and postoperative scar of the two methods were analyzed.Results The average time for harvesting the ear cartilage through posterior auricular approach and anterior auricular approach was(20.8±1.7)min and(12.6±1.1)min,respectively(P<0.01).The overall complication rate was 15.6%for posterior auricular approach group and 4.8%for anterior auricular approach group.The wound healed well in both groups,and there was no significant difference in postoperative scar between the two groups during an average 13 months follow-up period.Conclusions While both the anterior and the posterior auricular approaches present with similar inconspicuous scarring,the use of anterior auricular approach alone to harvest ear cartilage during rhinoplasty provides both the surgeons and the patients with easier access,shorter surgical duration,and fewer complications.Hence,we believe that the anterior auricular approach possesses greater advantages than the posterior auricular approach.

关 键 词：鼻 外科 整形 耳软骨 耳前入路 耳后入路 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]