自体耳软骨联合硅胶假体在隆鼻术后再次鼻整形中的应用

Application of autogenous auricular cartilage combined with silicone prosthesis in revision rhinoplasty after the augmentation rhinoplasty

目的 探讨自体耳软骨联合硅胶假体移植在再次鼻整形中的应用价值.方法 对29例初次应用硅胶假体隆鼻术形态欠佳的患者,使用自体耳软骨联合硅胶假体移植进行修复.结果 本组29例患者随访3~12个月,27例鼻部形态良好,鼻背延长,鼻尖抬高,鼻唇角角度改善,鼻尖皮肤无红肿,未发现假体外形显露、下移、排异反应等并发症,手术效果满意.其中2例患者术后拆线时发现鼻背部不对称,予以假体包囊分离缝合固定后效果满意.结论 自体耳软骨联合硅胶假体能延长鼻背,抬高鼻尖,有效防止鼻尖假体外形显露、张力过大、皮肤变薄、鼻尖皮肤穿孔等并发症发生,手术效果满意,值得推广.

Objective To discuss the application of autogenous auricular cartilage combined with sili- cone prosthesis implantation in revision rhinoplasty after the augmentation rhinoplasty. Methods A series of 29 patients with unsatisfied nasal contour after augmentation rhinoplasty with silicone implant were employed in this study and the deformities were corrected by autogenous auricular cartilage combined with silicone prosthesis implantation. Results All cases were followed up for 3 - 12 months postoperatively. Twenty-seven patients were satisfied with their nasal shape without prosthesis exposure, downward removal and rejection except for 2 patients with asymmetric nasal dorsum, which improved by dissecting prosthesis pocket and suturing fixation. Conclusion The autogenous auricular cartilage combined with silicone prosthesis can lengthen the dorsum and raise the nasal tip, which can prevent such complications as prosthesis exposure, high tension, skin thinning, perforation or rejection. Therefore, it is deserved to recommend clinical application.