内镜辅助鼻成形术

Rhinoplasty assisted with endoscopy

目的 探讨内镜技术应用于鼻成形的方法和效果.方法 在内镜辅助下采用鼻背假体置入与自体鼻中隔软骨扩展移植和＂盾牌状＂＂帽状＂移植重塑鼻尖,对32例（18~30岁）女性求美者进行了鼻成形手术.结果 术中所有制备隧道均无错层分离或形成假道,隧道内阻挡性束带可被内镜发现并及时解除.内镜能清楚显示鼻中隔结构,切取更加精确和容易.所有求美者创伤小,既无医源性意外创伤,也无一例出现假体偏斜、鼻中隔出血、血肿、穿孔、鼻背塌陷、假体外露和后期感染等并发症.术后随访6~12个月,全部求美者鼻形态满意,鼻背高度与长度正常,鼻尖突度改善,轮廓自然.结论 内镜直视下的鼻成形术是一种矫治鼻畸形安全、可行、有效的微创技术.内镜在鼻成形术中的应用有助于获得良好的手术效果.

Objective To explore the method and effect of the endoscopic technique on the rhinoplasty. Methods Under the endoscope, 32 female （18 -30 years old） with the nasal reshaping demands were per- formed the alloplastic implantation with prosthesis of nasal dorsum and nasal tip reconstruction by extended transplantation of autologous nasal septal cartilage and ＂shield-shaped＂ or ＂cap-shaped＂ transplantation. Re- sults There were no muhilayer dissection or false passage formed among the intraoperative prepared tunnels and under endoscope, the fibrous band was observed easily and cut promptly and the structure of the nasal sep- tal cartilage was shown clearly and taken exactly. There were not any postoperative complications, like large wound, deviation and exposure of prosthesis, bleeding, haematoma, and perforation of nasal septum and de- pression of nasal dorsum. After 6 - 12 following up, all patients were satisfied with the nasal contour, the height and length of the nasal dorsum and improved nasal tip. Conclusion The endoscopic approach is a via- ble option in rhinoplasty and a minimally invasive technique that helps us to correct the nasal deformity under excellent visualization. Endoscopy-assisted rhinoplasty is feasible, safe, and effective.