蝶形复合耳郭组织移植矫治重度短鼻缺陷

Lengthening of the serious short nose with papilionaceous concha composite graft

目的:为探讨重度短鼻的有效修复方法。方法:通过8例短鼻缺陷受术者采用蝶形复合耳郭组织游离移植到鼻尖鼻翼以增加鼻尖鼻翼的组织量以达到延长短鼻的目的,手术分为三个步骤:首先从鼻小柱基底到两侧鼻翼内缘做V形切口,广泛分离鼻尾端皮肤粘膜;然后,通过硅胶或ePTFE假体材料间插并缝合于两侧大翼软骨之间延长鼻尖部软骨支架;最后,将蝶形耳后复合组织块移植到切口部以增加鼻尖鼻翼部的组织量,术后观察该法延长短鼻的实际效果。结果:所有8例移植物均得到完全成活,鼻长延长4～7mm,鼻唇角可减少10～30度,均达到理想的美学角度。结论:该法可有效增加鼻尖鼻翼部组织量,从而可作为重度短鼻矫正术的有效补充。

Objective To improve the method of lengthening the serious short nose. Methods we developed a surgical technique to correct short nose by increase tissue volume in nasal tip ,nasal alae and the columella. The technique contain three steps： ① Wide dissection and prolongation of the outer skin envelope to cover the lengthened framework by a ＂V＂ formed surgical approach from columellar base to inner edge of alae. ②Silicone or expanded polytetrafluoroethylene [ePTFE] implant is used to correct saddle nose and to length nasal framework. ③ A papilionaceous concha composite graft containing a elliptic ear cartilage and a onlay ＂V＂ formed skin and subcutaneous tissue is grafted to inner edge of columella and alae. Results we performed the procedure on 8 patients. During follow-up period of 3 to 6 months, the grafts in all 8 patients survived completely, and after the lengthening procedure, the nasolabial angle improved 10-40 degrees, nasal length extended 4-7mm. Conclusion This technique can be an effective supplement for repairing serious short nose deformity by increasing the tissue volume of nasal tip and nasal alae.