自体双侧耳甲艇软骨改良支架在鼻整形中的应用效果分析  

Application of the modified scaffolds of autologous bilateral auricular concha cartilage in rhinoplasty

作　　者：靳海涛 李佳佳 刘代明 侯玉洁 刘奕 田毅 Jin Haitao;Li Jiajia;Liu Daiming;Hou Yujie;Liu Yi;Tian Yi(An Beili Medical Beauty Clinic,Shimen County,Changde 415300,China;Qianyi Medical Beauty Clinic,Kaifu District,Changsha 410008,China;Department of Wound Repair,the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410005,China)

机构地区：[1]湖南省常德市石门县安蓓丽医疗美容门诊部,常德415300 [2]湖南省长沙市开福区芊亿医疗美容门诊部,长沙410008 [3]湖南中医药大学第二附属医院创面修复科,长沙410005

出　　处：《中华医学美学美容杂志》2024年第6期565-570,共6页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：湖南省自然科学基金(2023JJ40498)。

摘　　要：目的探讨自体双侧耳甲艇软骨改良支架在鼻整形中的应用效果。方法回顾性纳入2020年1月至2022年1月湖南省常德市石门县安蓓丽医疗美容门诊部进行鼻整形术的219例患者,其中男8例,女211例,年龄(28.7±5.5)岁。所有患者均接受应用自体双侧耳甲艇软骨改良支架进行鼻整形手术,其中157例患者为首次接受鼻整形术,62例患者为2次鼻整形修复手术。切取双侧耳甲艇软骨,采用对称分割、对位缝合等方式制作鼻小柱支撑移植物和防鼻尖旋转移植物,构建鼻尖形态。鼻背使用热塑夹板及胶带固定,鼻腔用膨胀海绵填塞,术后常规预防性使用抗生素48 h,并于术后8~10 d视伤口愈合情况拆线。对患者进行门诊随访,评估手术疗效及患者满意度。结果219例患者均采用局部浸润麻醉进行手术,鼻背主要使用柳叶形假体,其中145例患者采用硅胶假体,74例患者采用膨体,平均手术时间为(72.92±13.26)min。所有患者均在术后8~10 d内拆线,手术切口愈合良好,219例患者对术后即刻的鼻部外形均表示满意。平均随访时间为(14±2)个月,鼻尖高度平均抬高(4.7±0.5)mm;鼻部长度平均延长(5.7±0.6)mm。219例患者中,对鼻部形态满意的患者占比为96.8%(212/219),术后鼻部形态符合自然美学标准,鼻尖表现点明显,鼻尖外形圆润,鼻背自然高挺。其余4例患者术后出现鼻尖下旋,3例患者术后出现鼻部慢性感染。结论利用双侧耳甲艇软骨搭建的鼻尖软骨改良支架能在鼻整形术后获得更好的鼻部外观及鼻尖活动度。ObjectiveTo investigate the effectiveness of autologous bilateral auricular concha cartilage-modified scaffolds in rhinoplasty.MethodsRetrospectively,219 patients aged(28.7±5.5)years,8 males and 211 females,who underwent rhinoplasty at the An Beili Medical Beauty Clinic in Shimen County,Changde City,Hunan Province,from January 2020 to January 2022,were included.Every patient consented to apply modified scaffolds of autologous bilateral auricular concha cartilage for rhinoplasty;157 received primary rhinoplasty and 62 underwent secondary rhinoplasty repair.To construct the nasal tip morphology,bilateral auricular concha cartilage was excised,symmetrically divided and aligned sutures to form nasal columellar support grafts and anti-tip rotation grafts.Thermoplastic splints and tape were used to fix the dorsum of the nose,and tumescent sponges to fill the nasal cavity.Prophylactic antibiotics were routinely administered after surgery for 48 hours,and depending on how well the wound healed,the stitches were taken out 8 to 10 days later.ResultsA local infiltration anesthetic was used throughout the procedure on all 219 patients.The majority of patients had a willow-shaped prosthesis constructed for the dorsum of their noses.A total of 145 patients had silicone prostheses,and 74 patients had expanded polytetrafluoroethylene prostheses.The mean operating duration was(72.92±13.26)minutes.Within 8 to 10 days after surgery,all patients had their sutures taken out,the surgical incisions healed properly,and all 219 patients were satisfied with their nasal appearance in the immediate postoperative period.The nasal tip height was elevated by an average of(4.7±0.5)mm,and the nasal length was extended by an average of(5.7±0.6)mm over the mean follow-up of(14±2)months.Among 219 patients,96.8%(212/219)of the patients expressed satisfaction with the form of their noses.The postoperative nasal shape,with its naturally elevated nasal dorsum,rounded tip profile,and pronounced tip-defining point,complied with the natural aesthetic

关 键 词：耳甲艇软骨 支架 鼻综合整形 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]