带软骨膜的肋软骨支架在鼻综合整形术中的应用  

Application of costal cartilage framework with perichondrium scaffold in comprehensive rhinoplasty

作　　者：钟爱 李正勇[1] 陈俊杰[1] ZHONG Ai;LI Zheng-yong;CHEN Jun-jie(Department of Cosmetic and Plastic Burn Surgery,West China Hospital,Sichuan University,Chengdu Sichuan 610041,China)

机构地区：[1]四川大学华西医院美容整形烧伤外科,四川成都610041

出　　处：《局解手术学杂志》2024年第8期727-731,共5页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨一种全新的带软骨膜的肋软骨支架预搭建鼻综合整形术的临床应用效果。方法回顾性分析2017年12月至2022年12月我院采用带软骨膜的肋软骨支架预搭建行鼻综合整形术的40例患者临床资料。观察患者术后鼻尖张力及鼻小柱皮瓣血运、围术期并发症发生情况。基于患者手术前后的面部照片测量鼻背长度、鼻尖高度、鼻唇角变化,评价患者主观满意度。结果40例患者手术进展顺利,术中出血量少,无围术期并发症,术后伤口均一期愈合。随访12~36个月,未发现假体移位、假体脱出、软骨支架移位变形或弯曲;1例患者发生细菌感染,经对症治疗后伤口愈合。与术前比较,患者术后鼻背长度、鼻尖高度明显增加,鼻唇角明显增大,差异均有统计学意义(P<0.001)。在形态效果方面,患者术后主观满意度为97.5%。结论预搭建带软骨膜的肋软骨支架应用于鼻综合整形术安全可靠,效果较好,并发症少,患者满意度高。Objective To explore the clinical application effect of a novel prefabricated costal cartilage framework with perichondrium scaffold in the comprehensive rhinoplasty.Methods A retrospective analysis was conducted on the clinical data of 40 patients who underwent comprehensive rhinoplasty by using a prefabricated costal cartilage framework with perichondrium scaffold from December 2017 to December 2022 in our hospital.The postoperative tension of nasal tip,blood supply of nasal columella skin flap,and occurrence of perioperative complications were observed.The changes of nasal dorsum length,nasal tip height,and nasolabial angle before and after surgery were measured based on facial photographs taken to evaluate patients'satisfaction.Results The surgeries on 40 patients were successfully performed,with a less intraoperative bleeding and few perioperative complications.All postoperative wounds healed in the first phase.After 12 to 36 months of follow-up,no implant displacement,implant extrusion,or cartilage framework displacement,deformation or bending was found.One patient developed bacterial infection,who healed after symptomatic management.There were significant increases in the nasal dorsum length,nasal tip height,and nasolabial angle after operation compared with those before operation,with statistically significant differences(P<0.001).The patients'satisfaction in terms of morphological outcomes after surgery was 97.5%.Conclusion The application of prefabricated costal cartilage framework with perichondrium scaffold in comprehensive rhinoplasty is safe and reliable,with good outcome and fewer complications,as well as high patients'satisfaction.

关 键 词：鼻整形 肋软骨支架 鼻中隔 鼻唇角 鼻小柱 

分 类 号：R622[医药卫生—整形外科]