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自体颗粒肋软骨移植隆鼻的临床应用
目的 探求易塑形且不易变形的隆鼻方法,以降低自体肋软骨隆鼻术后,软骨易发生变形的可能.方法 2012年6月至2014年3月,共61例患者接受颗粒肋软骨植入隆鼻术.术前及术后随访均拍摄标准化照片并对患者进行满意度调查.结果 在61例患者中,其中25例为隆鼻术后要求修整的患者.术后59例患者对鼻部形态表示满意;1例因鼻根部过高需要再次手术修整;1例患者穹窿部上方出现局部凹陷,通过手法软骨复位及鼻夹外固定后得到改善.无感染及软骨变形、软骨移位及软骨外露的出现.结论 颗粒软骨结合条状软骨植入隆鼻的方法,可塑造出良好的鼻部形态,且操作简便,对于具备一定的手术适应证的初次隆鼻患者和隆鼻术后修整的患者,是可以选择的方法之一.
Abstract:
Objective Augmentation rhinoplasty is a commonly procedure in clinical work for a plastic surgeon.Autologous costal cartilage is widely used in aesthetic rhinoplasy because of the abundant in quality.However,the cartilage may warp,and it is not easy-handling for inexperienced plastic surgeons.We used diced cartilage combined with thin strips as columellar struts,which can be easily shaped,and reduce the warping incidence.Methods From July 2012 to March 2014,61 patients were performed diced costal cartilage for nasal augmentation via endonasal approach.Standardized photographs are obtained before and after surgery.Postoperative outcome is graded by patient' s self-evaluation of the nasal appearance with a satisfaction scale.Results Among the 61cases,25 were revision cases.The follow-up time was no less than 6 months,with an average time of 10.9 months.28 patients reported improved or better nasal appearance.One patient required revision surgery because of overcorrection.Supratip step-off was observed in one patient and corrected by external reshaping.No warping,infection,irregularity,absorption,airway obstruction,or donor-site morbidity were observed.All patients were satisfied with the final appearance.Conclusions Diced costal cartilage is a reliable option for nasal augmentation and revision rhinoplasty.Good outcomes can be achieved postoperatively,with aesthetically pleasing appearance and simple procedure.
Ma Jiguang
Wang Keming
Wang Chunhu
Zhao Xiaohui
Zhang Tiran
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中国医学科学院整形外科医院整形十七科, 北京,100144
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