先天性鼻筛窦道假性三鼻孔畸形的诊断和整形修复

Diagnoses and plastic reconstruction of congenital nasal ethmoidal sinus malformation with false triple nostrils appearance

目的探讨先天性鼻筛窦道假性三鼻孔畸形的发病原因、诊断标准和有效治疗方法。方法对1993年2月至2006年3月13例先天性鼻筛窦道假性三鼻孔畸形从发病原因、临床表现、鉴别诊断、手术方法等进行了系统研究。采用窦道切除、重建再造筛窦开口、鼻表浅肌肉腱膜瓣移植、鼻唇沟皮瓣移植、鼻翼软骨肌肉环修复重建等综合手术方法一期整形修复。结果13例术后均自觉症状消失，双侧对称，外形满意，无并发症发生。结论应用窦道切除、再造重建筛窦开口、鼻唇沟皮瓣移植、鼻表浅肌肉腱膜瓣移植及鼻翼软骨肌肉环修复重建等综合手术方法一期整形修复，是治疗先天性鼻筛窦道假性三鼻孔畸形的安全有效方法。

Objective To study the pathogenesis, the diagnostic criterion and the surgical methods of congenital nasal ethmoidal sinus malformation with false triple nostrils appearance. Methods From Feb 1993 to Mar 2006, a total of 13 cases of rare congenital nasal deformity had been investigated in pathogenesis, clinical manifestations, differential diagnosis and the methods of operation. The concept of congenital nasal sinus was presented. In this series, one-stage rehabilitation was achieved by using compositive operation techniques, including excision of the sinus, reconstruction of the hatch of ethmoidal sinus, transplantation of the dorsal nasal musculoponeurotic flap as well as the nasolabial fold flap and the reconstruction of the cartilage-muscle ring in the wing of the nose. Results The symptom disappeared in all of the 13 cases with no morbidity. The symmetrical double sides were observed and the nasal figure was satisfied. Conclusions By using such compositive operation techniques, including excision of the sinus, reconstruction of the hatch of ethmoidal sinus in middle masolabial, transplantation of the dorsal nasal musculoponeurotic flap as well as the nasolabial fold flap and the reconstruction of the cartilage-muscle ring in the wing of the nose, one-stage rehabilitation could be reached. It was an ideal, safe and reliable method to cure this kind of rare congenital nasal deformity.