e-PTFE在唇裂术后继发鼻畸形修复中的拓展应用

Development of nasal deformity correction of cleft lips by e-PTFE

目的:探索扩大e-PTFE在唇裂术后继发鼻畸形整复中的安全应用范围及方法。方法:将e-PTFE雕刻成柳叶状置于鼻背筋膜下垫高鼻背和鼻根部,另雕刻厚约2mm的近似梯形的膨体片置于下外侧软骨内侧脚和中隔软骨尾侧端之间,重建鼻小柱支撑并抬高和延长鼻尖。结果:27例II度-Ⅲ度唇裂术后继发鼻畸形中有3例术后1个月内鼻尖和鼻小柱出现发红、触痛等轻度"炎症"表现,局部处理后好转。其余切口均Ⅰ期愈合,形态满意。结论:e-PTFE在唇裂术后继发鼻畸形整复中的安全应用范围不仅仅是垫高鼻根部和鼻背部,在完善每个技术环节的基础上亦可将之拓展应用于鼻小柱支撑重建、延长鼻尖及鼻尖塑形等方面,较之软骨移植它取材方便而且无限量,减少了软骨移植的创伤和繁复。

Objective To explore the safe application area of e-PTFE at the nasal deformity of cleft lips.Methods To augment the nasion and back of nose by a piece of e-PTFE which looks like a leaf of wollow.Put another piece of trapeziform e-PTFE which thickness is about 2mm between the nasal septal cartilage and lower lateral cartilages.Results All 27 cases were satisfactory with their shape of noses.The follow-up data were obtained in 17 cases,with time range of 3～12 months.Flare and pain of nasal tips and columella occurred in 3 cases within the first month.These symptoms disappeared after local processing.Conclusions e-PTFE can not only augment the nose,but also can re-construct and reinforce the anchorage force of nasal columella and extend nose in length safely.