自体肋软骨移植构建鼻尖软骨复合体在鼻整形中的临床应用

Clinical application of construction of nasal tip cartilage complex with autologous costal cartilage graft in the nasal plastic

目的:通过应用自体肋软骨重塑鼻尖软骨支架结构,形成稳定的鼻尖软骨复合体,来达到完美、立体的鼻尖外形,同时应用膨体聚四氟乙烯或硅胶假体支架抬高鼻背,从而达到理想的鼻部整形美容效果。方法:以鼻小柱基底部"几"字形切口和鼻孔内鼻翼软骨外侧缘切口,彻底分离皮肤达鼻翼基底部,对鼻尖短小朝天者可松解到达梨状孔边缘,显露两侧鼻翼软骨及侧鼻软骨,同时暴露鼻中隔软骨游离端;雕刻自体肋软骨,移植、固定到鼻中隔软骨上,贯穿缝合鼻翼软骨、移植的软骨,形成鼻尖软骨支架结构,构建鼻尖软骨复合体。雕刻膨体聚四氟乙烯或硅胶假体支架放置到鼻背鼻骨骨膜下抬高鼻背。结果:本组96例手术者均采用自体肋软骨移植构建鼻尖软骨复合体行鼻整形,术后7天拆线,切口Ⅰ/甲愈合。随诊6～12个月,95例术后鼻尖表现点明显,鼻形立体、挺拔,自然美观,鼻尖活动度好,效果满意。1例术者感觉鼻小柱下垂,通过修复移植软骨,达到满意效果。结论:应用自体肋软骨重塑鼻尖软骨支架结构,构建鼻尖软骨复合体,同时应用膨体聚四氟乙烯或硅胶假体支架抬高鼻背,可以达到理想的鼻部整形美容效果。

Objective To reshape the nose with autologous costal cartilage,to form a stable complex,to achieve a perfect,three-dimensional tip shape,while elevating nose dorsum with expanded polytetrafluoroethylene or silicone prosthesis stent to achieve the desired effect of nasal plastic surgery.Methods a＂几＂shaped incision at the base of the nasal columella,and a incision in the lateral alar cartilage of the nostril,incision separate the dorsum skin until pyriform aperture to expose both sides of the alar cartilage and lateral nasal cartilage,and expose the free end of the septal cartilage;sculpture autologous rib cartilage,transplant,fixed to the septal cartilage,suture alar cartilage through the transplantation of cartilage,form a nasal tip cartilage,build nose cartilage complex.Place an engraving expanded polytetrafluoroethylene or silicone prosthesis stent to raise the dorsum subperiosteal nasal.Results 96 patients with surgery of constructing complex nasal tip cartilage with autologous rib cartilage graft,7 days after suture removal,wound Ⅰ/ A healed.Followed up for 6 to 12 months,95 cases were obvious tip of the nose point performance,nose-shaped three-dimensional,upright,natural,beauty,a good tip activity,the effect is satisfactory.One case of surgery hanging columella feel,through the repair of cartilage transplantation,achieve satisfactory results.Conclusion Building nose cartilage complex and remodeling,complex nose cartilage with autologous costal cartilage,while application of expanded polytetrafluoroethylene or silicone prosthesis stent elevation dorsum,you can achieve the desired effect of nasal plastic surgery.