鼻整形中硅胶假体分别联合肋软骨、耳软骨与同种脱钙骨基质的临床对比研究  

A clinical comparative study of silicone prosthesis combined with costal cartilage,auricular cartilage and allogeneic decalcified bone matrix in rhinoplasty

作　　者：孟雪勇 杨亦 马志兵 褚庭纲 葛陈 黄金龙 MENG Xueyong;YANG Yi;MA Zhibing;CHU Tinggang;GE Chen;HUANG Jinlong(Department of Plastic Surgery,Affiliated Hospital of Nanjing University of Chinese Medicine(Jiangsu Prouince Hospital of Chinese Medicine),Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院(江苏省中医院)整形美容外科,江苏南京210029

出　　处：《中国美容整形外科杂志》2025年第1期30-34,I0012,共6页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨硅胶假体分别联合肋软骨、耳软骨与同种脱钙骨基质在鼻整形中的效果差异。方法回顾性分析自2021年9月至2023年8月,于南京中医药大学附属医院(江苏省中医院)整形美容外科57例行鼻整形术患者的临床资料。根据患者采用的鼻尖支架类型分为同种脱钙骨基质组(23例)、肋软骨组(16例)和耳软骨组(18例),3组均采用相同的方式搭建鼻尖支架、鼻背均采用硅胶假体填充。测量患者术前、术后6个月的鼻尖突出度和鼻唇角评估鼻支架的稳定性;术后随访时观察切口愈合、术后并发症和术后6个月患者满意度;术后1个月、6个月采用MRI评估移植骨及移植骨旁软组织情况。结果术后随访6~12个月,平均(9.6±1.7)个月。所有患者术后切口均一期愈合,未发生并发症,影像学提示,移植物形态均规整,层次清晰,无明显移位或者变形,未观察到炎症反应或感染迹象。3组患者术后6个月满意度评分比较,差异无统计学意义(P>0.05);3组患者鼻尖突出度和鼻唇角术前、术后6个月组间比较,差异均无统计学意义(P>0.05)。结论鼻整形手术中采用同种脱钙骨基质搭建鼻尖支架,无需切取自身软骨,可以缩短手术时间,能够避免软骨供区的相关并发症,且对术者的软骨雕刻技术要求较低,搭建方式简单方便,支架稳定性好,术后效果与自体软骨无明显差异,是一种高效安全的替代性移植材料。Objective To investigate the differences in the clinical effects of silicone prosthesis combined with costal cartilage,auricular cartilage and allogeneic decalcified bone matrix in rhinoplasty.Methods A retrospective analysis was conducted based on the clinical data of the patients who underwent rhinoplasty from September 2021 to August 2023.Based on the type of nasal tip framework used,patients were divided into three groups:allogeneic decalcified bone matrix(DBM)group(n=23),costal cartilage group(n=16),and auricular cartilage group(n=18).All groups underwent the same surgical method for constructing the nasal tip scaffold,while silicone prosthesis was utilized to fill the nasal dorsum.The stability of the nasal strut was evaluated by measuring the nasal tip projection and nasolabial angle before surgery and 6 months after surgery.Postoperative follow-up included assessment of incision healing,postoperative complications,and patient satisfaction at 6 months.MRI evaluation of the transplanted bone and surrounding soft tissue was performed 1 and 6 months after surgery.Results The follow-up period was(9.6±1.7)months(6 to 12 months).All groups exhibited primary wound healing without any complications.Imaging assessments revealed well-maintained graft integrity with clear layers,absence of displacement or deformation,and no signs of inflammation or infection.There was no significant difference in average satisfaction among the 3 groups,which was not statistically significant(P>0.05).There was no significant difference in nasal tip projection and nasolabial angle among the 3 groups at 6 months postoperatively,with no statistical significance(P>0.05).Conclusion The utilization of allogeneic decalcified bone matrix for constructing a nasal tip scaffold in rhinoplasty can effectively reduce operation time and prevent complications associated with cartilage donor sites,while also requiring minimal expertise in cartilage carving techniques.This construction method is straightforward and convenient,ensuring excellent stabi

关 键 词：鼻整形术 鼻支架 耳骨支架 肋软骨支架 同种脱钙骨基质 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]