自体肋软骨块状联合颗粒状填充矫正鼻旁区凹陷的效果  

Paranasal augmentation using autologous costal cartilage as an adjunct to rhinoplasty

作　　者：杨济泽 袁含力 黄智华 赵耀忠 江华[3] 刘安堂 Yang Jize;Yuan Hanli;Huang Zhihua;Zhao Yaozhong;Jiang Hua;Liu Antang(Department of Plastic Surgery,Shanghai General Hospital,Shanghai Jiao Tong UniversitySchool of Medicine,Shanghai 200080,China;Department of Plastic Surgery,Shanghai Chang zheng Hospital,Navy Medical University,Shanghai 200003,China;Department of Plastic Surgery,Shanghai East Hospital Affiliated to Tongji University,Shanghai 200085,China)

机构地区：[1]上海交通大学附属第一人民医院整形外科,上海200080 [2]海军军医大学附属长征医院整形外科,上海200003 [3]同济大学附属东方医院整形外科,上海200085

出　　处：《中华医学美学美容杂志》2023年第1期29-32,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的:探讨自体肋软骨块状联合颗粒状填充鼻旁区凹陷的效果。方法:2016年1月至2019年12月,海军军医大学附属长征医院整形外科收治76例行自体肋软骨隆鼻患者,男8例、女68例,年龄18~38岁,平均23.1岁。进行自体肋软骨鼻整形同时,联合用块状和颗粒状软骨行鼻旁区域填充,定期随访;分析并发症并评估手术效果。结果:术后随访6~34个月,平均17.2个月;术区无感染和移植物外露,术后未出现气胸、胸廓变形、通气障碍及其他功能障碍。填充效果主观满意度评分(3.4±0.5)分。术前鼻唇角(78.2±13.2)°,术后6个月随访时鼻唇角(89.8±10.2)°,改善明显(t=152.00,P<0.01)。鼻旁区抬升明显,鼻翼至左耳屏间切迹的距离增加2.2~6.1(3.8±2.1)mm。结论:肋软骨隆鼻联合鼻旁区填充手术可纠正鼻旁区凹陷,术后效果稳定,术后并发症少,对于咬合关系正常或轻度异常的患者具有较好效果。Objective To investigate the postoperative effect of paranasal concavity augment by block united with diced autologous costal cartilage.Methods The data of 76 patients who were underwent costal cartilage rhinoplasty together with paranasal augmentation from January 2016 to December 2019 were analyzed retrospectively.The surgical technique was described in detail.Medical charts and operative records were reviewed to summary the complications.Patients′subjective satisfaction of the postoperative nasal appearance was self-evaluated with grading(1 worse,2 no change,3 improved,and 4 much improved).Cosmetic effects were evaluated by the measurements of the nasolabial angle and the distance between ACJ and intertragic notch preoperatively and postoperatively.Results The postoperative follow-up duration was 6 to 34 months.Overall,functional and aesthetic outcome was satisfactory in most patients,and the mean score by the patients′self-evaluation was 3.4±0.5.Graft exposure,mobility,or significant resorption,pneumothorax or significant donor-site pain were not observed.The average nasolabial angle was changed from(78.2±13.2)°preoperatively to(89.8±10.2)°6 months postoperative at the last follow-up(t=152.00,P<0.01).And the distance from the alar-cheek junction to the left tragus was increased by 3.8±2.1(2.2-6.1)mm.Conclusions Costal cartilage rhinoplasty combined with augmentation of parasal area can improve parasal depression,with stable postoperative effect and fewer postoperative complications,and has a good effect for patients with normal occlusal relationship or mild abnormality.

关 键 词：鼻 外科 整形 鼻旁区填充 自体肋软骨 中面部凹陷 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]