不对称蝶形切口联合自体软骨修复唇裂继发鼻畸形  

Bilateral Asymmetric Butterfly Incision Combined Autologous Cartilage to Correct the Nasal Deformity Secondary to Cleft Lip

作　　者：范鹏飞 王凯[3,4] 侴海燕[3,4] 李磊 Fan Pengfei;WANG Kai;CHOU Haiyan;LI Lei(Department of Plastic and Aesthetic Surgery,Hainan General Hospital,Haikou 570311,Hainan,China;Hainan Affiliated Hospital of Hainan Medical University,Haikou 570311,Hainan,China;Department of Plastic and Aesthetic Surgery,Henan University People’s Hospital,Zhengzhou 450003,Henan,China;Department of Plastic and Aesthetic Surgery,Henan People’s Hospital,Zhengzhou 450003,Henan,China)

机构地区：[1]海南省人民医院整形美容外科,海南海口570311 [2]海南医学院附属海南医院,海南海口570311 [3]河南大学人民医院整形美容外科,河南郑州450003 [4]河南省人民医院整形美容外科,河南郑州450003

出　　处：《中国美容医学》2023年第6期4-8,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探索应用双侧不对称蝶形切口联合自体软骨移植修复单侧唇裂继发鼻畸形的手术方法与效果。方法:选取2018年8月-2022年1月收治的46例单侧唇裂继发鼻畸形患者,年龄14~36岁,平均24.6岁。采用不对称蝶形切口联合自体软骨移植修复鼻背缺陷、鼻尖突出度不足、鼻翼畸形、鼻中隔偏曲等畸形,恢复鼻对称三维立体结构及美学效果,并利用主观和客观两种评价方法对术后效果进行评定。结果:所有患者术后切口Ⅰ期愈合,44例患者术后切口瘢痕不明显,2例患者术后切口出现增生,经积极抗瘢痕治疗后,瘢痕明显减轻,效果满意。所有患者均获随访,随访时间3~12个月,平均6.8个月,终末随访时进行效果评价。46例患者鼻背、鼻尖、鼻翼及鼻小柱改善明显,主观评价平均分97.6分;客观指标方面,角α矫正率为30.56%;鼻孔的纵径、横径矫正率分别为13.30%、13.50%;对比值分别为1.03、0.93。结论:不对称蝶形切口联合自体软骨移植修复单侧唇裂继发鼻畸形进行综合整复,可以很好地对鼻背、鼻尖、鼻翼、鼻小柱进行矫正,临床效果良好。Objective To explore the surgical method and effect of bilateral asymmetric butterfly incision combined with autologenous cartilage transplantation to repair secondary nasal deformity of unilateral cleft lip.Methods From August 2018 to January 2020,46 cases patients of secondary nasal deformity of unilateral cleft lip,aged 14-36,the average age is 24.6.They were treated with asymmetric butterfly incision combined with autogenous cartilage transplantation to repair the deformities such as the defect of nasal dorsal defects,insufficient protrusion of nasal tip,alar deformity,nasal septum deviation and other malformation,to restore the aesthetic efiect of the symmetrical three-dimensional structure of the nose,and the postoperative efiect was evaluated by subjective and objective methods.Results All patients with postoperative incisionⅠhealing,incision scar is not obvious,followed up for 3-12 months,an average of 6.8 months,in efiect at the time of flnal follow-up evaluation.From August 2018 to January 2020,46 cases of unilateral cleft lip secondary nasal deformity were treated,aged 14-36 years(female minimum 14 years,male minimum 16 years),with an average age of 24.6 years,all incisions healed with primary healing,and the scar was not obvious.All the patients were followed up for 3-12 months,with an average of 6.8 months,and the efiect was evaluated at the end of follow-up.The improvement of nasal dorsal,tip,alar and columella was significant in 46 patients,with an average subjective score of 97.6.In terms of observing indicators,the correction rate of angleαwas 30.56%,the correction rate of longitudinal diameter and transverse diameter of nostril was 13.30%and 13.50%,the comparison value was 1.03 and 0.93 respectively.Conclusion Asymmetric butterfly incision combined with autogenous cartilage transplantation can be used to repair secondary nasal deformity of unilateral cleft lip,which can correct nasal dorsum,tip,alar and columella with good clinical efiect.

关 键 词：唇裂 鼻畸形 皮瓣 自体软骨 人体测量学 不对称蝶形切口 

分 类 号：R622[医药卫生—整形外科]