单根肋骨-软骨重塑移植治疗Binder综合征

Primary report of single rib-cartilage recombination transplantation in Binder syndrome treatment

目的 探讨单根肋骨-软骨重塑移植治疗Binder综合征的手术方法及效果.方法 对5例Binder综合征患者,于术中切取第7肋软骨和相连的部分肋骨,初步雕刻分成3部分：1块I形软骨、1块倒T形软骨和1块由肋骨及软骨组成的C形植入体,C形植入体从中央纵行劈开分成C形和反C形2部分.I形、倒T形软骨组合成L形植入体,用来增高鼻背、支撑鼻小柱和升高鼻基底.C形和反C形2块植入物用于填充梨状孔周围.结果 术后5例患者对畸形矫正效果均满意,并均获18 ～30个月随访.患者鼻部和面中部的升高均维持在正常位置,鼻部支架也未出现偏斜.结论 单根肋骨-软骨重塑移植治疗Binder综合征,手术创伤小,术后患者恢复良好,效果满意.

Objective To explore the surgical methods and advantages of single rib-cartilage recombination transplantation in Binder syndrome treatment. Methods Five patients were treated with single rib-cartilage recombination transplantation. We harvested only the seventh costal cartilage including partial costal bone of the same rib to correct all the deformities. The rib was divided into 3 parts： 1 I- shaped cartilage, 1 inverted-T-shaped cartilage, and 1 C-shaped implant （later divided into a C and a reversed-C implant） composed of rib bone and cartilage. The first 2 parts were constructed to an L-shaped implant for nasal dorsum augmentation, collumella support, and nasal base elevation. The C-shaped and reversed-C-shaped implants were placed on both sides of the pyriform aperture. Results All patients were followed up for eighteen to thirty months. No apparent deviation on the nasal support was found. Conclusion Single rib-cartilage recombination transplantation in Binder syndrome treatment has lots of advantages, such as less morbidity, rapid recovery, and good results.