自体软骨在短鼻合并鼻尖圆钝低平修复中的应用

Application of autologous cartilage graft in plastic surgery of aesthetically short nose with low and bluntnasal tip

目的 探讨自体软骨移植在短鼻合并鼻尖圆钝低平的修复中的心用和效果。方法通过外切口进路，取自体鼻中隔软骨或同时取耳廓软骨，必要时另取肋软骨，行鼻中隔延伸移植、鼻软骨小柱条支撑移植、鼻尖结构移植，同时结合鼻尖缝合和软骨、软组织切除技术修复鼻尖。在术前和术后3个月，分别测量鼻长度和鼻尖突出度，然后进行配对t检验的统汁学分析。结果应用自体软骨修复审美性短鼻合并鼻尖圆钝低平者31例。术后随访3个月，满意行30例，占96．7％，1例因出现术后双侧鼻孔不对称，而不满意，占3．3％。术前和术后3个月比较，鼻长度差异有统计学意义（P〈0．05），鼻尖突出度差异也有统汁学意义（P〈0．05）。结论应用自体软骨移植结合鼻尖缝合和切除术．修复短鼻合并鼻尖圆钝低畸形，效果满意。

Objective To explore more satisfactory results in correcting the aesthetically short nose combined with low and blunt nasal tip by using autologous cartilage grafts. Methods External rhinoplasty approach was preferred. Nasal septal cartilage and auricular cartilage or rib cartilage of pa- tients were adopted, as necessary, various shapes of grafts were carved, such as septal extention graft, columella strut and shift graft. Then we used these autologous cartilage grafts with suture and removal techniques to correct tile aesthetically short nose combined with low and blunt nasal tip. The length of the nose （n-prn） and the projection of nasal tip （sn-prn） were measured before and after the operation. Paired t-test was adopted to evaluate the results. Results Thirty-one patients accepted the nasal tip rhinoplasty with autologous cartilage whose nasal tip was over rotation, blunt and low. All the patients were followed up for 3 months. Thirty patients satisfied with the results, accounting for 96.7 %of the total. One （3. 3 % ） patient dissatisfied with the resuh because of postoperative asym- metry nostrils. Nose length before and after surgery was significantly different （P〈0.05）. Nasal tip projection before and after surgery was also significantly improved （P〈0. 05）. Conclusions It is an effective method to use autologous cartilage graft for correcting the aesthetically short nose combined with low and blunt nasal tip, with low complications.