全鼻肋软骨支架的鼻再造术

Total nasal reconstruction with total rib cartilage framework

目的探讨一种全鼻肋软骨支架的鼻再造新技术。方法用皮肤扩张术和皮瓣延迟术预制额部扩张皮瓣充当再造鼻部覆盖物，鼻背皮瓣翻转做新鼻衬里，以肋软骨材料制作全鼻整体支架结构再造初期新鼻，后期精细修复后完成再造。结果本组37例，经4～7次手术，全部成功实现全鼻再造，持续治疗时间6～8个月。再造手术后12～24个月随访32例，再造鼻皮肤色泽自然、瘢痕少、外形良好，触摸前鼻有弹性，且鼻孔对称、鼻腔通气好，医、患均满意。结论全鼻肋软骨支架的鼻再造技术可以获得良好的新鼻型和鼻孔通气功能。

Objective To investigate a new technique for nasal reconstruction with total rib cartilage framework. Methods The expanded frontal flap was fabricated by skin expansion and flap delay to cover the reconstructed nose. The dorsal flap was reversed as the lining of reconstructed nose. The whole framework was made by rib cartilage. Secondary revision operation was also performed to make the reconstructed nose more natural. Results Total nasal reconstruction was performed successfully in 37 cases. Each patient underwent 4-7 operation during a period of 6-8 months. 32 patients were followed up for 12-24 months. The reconstructed nose had a natural skin color and symmetric appearance with good ventilation and less scar. Both doctors and patients were satisfied with the results. Conclusion Satisfactory cosmetic result and ventilation function can be achieved by nasal reconstruction with total rib cartilage framework.