鼻骨畸形的临床分类和整形治疗

Clinical classification and surgical treatment of deformed nasal bone

目的探讨鼻骨畸形的分类及鼻骨畸形的截骨整形治疗的效果。方法以鼻中线和鼻骨椎体的前后位移为标准将鼻骨畸形分为塌陷型、侧偏型、塌陷与侧偏复合型、凸出型、鼻骨宽大型、鼻骨短小型和特殊型7个类型。本组78例患者中,52例行鼻骨截骨整形术矫正,26例行单纯隆鼻术。结果鼻骨截骨整形术矫正鼻骨畸形的52例中,48例术后鼻骨复位或显著改善,占鼻骨截骨病例的92%(48/52);4例塌陷型畸形Ⅰ期截骨术鼻骨高度矫正不足,再次行硅胶假体隆鼻术补充,占8%(4/52)。26例行单纯隆鼻术恢复满意。结论鼻骨畸形的临床分型具有简单、系统的特点,对临床整形治疗有指导作用;采用鼻骨截骨整形方法,是鼻骨畸形整复的有效手段。

Objective The deformed nasal bone is commonly seen in clinical practice of plastic surgery, and up to now, there is still lack of systemic classification to direct clinical treatment. Attempt was made in this study to classify the deformed nasal bone and present their plastic surgery treatment. Methods According to the orientation of the nasal bone deviation, the nasal bone deformities were divided into seven types, including the depressed, deviated, combination of the depressed and deviated, convex, widened, shortened ones and others. Of the 78 cases with the deformed nasal bone, 52 cases were corrected by the bone osteotomy techniques, and 26 cases by augmentation rhinoplasty. Results The satisfactory repair outcomes were achieved in 48 nasal bone deformities of the 52 cases （92%）, and then secondary procedures were performed in 4 cases for further improvements （8%）. Augmentation rhinoplasty in 26 cases showed good results. Conclusions Those types of classification are relatively simple and compre hensive, which is conducive to clinical treatment. The nasal bone osteotomy is effective to repair the deformed nasal bone.