应用自体鼻中隔软骨与自体真皮组织修复假体隆鼻术后远期并发症的临床研究

Research of long-term complications of implanted nasal augmentation with autologous septal cartilage and dermal tissue

目的探讨应用自体组织综合性修复假体隆鼻并发症的方法和疗效。方法针对36例固体硅胶假体隆鼻术后鼻背、鼻尖发红及鼻尖假体显露、穿出的患者，采取经鼻小柱开放性切口取出假体，剥除包膜，应用患者自体鼻中隔软骨及臀部真皮组织进行综合鼻整形修复。自体鼻中隔软骨应用于鼻小柱支撑及鼻尖覆盖物，白体真皮组织去表皮及脂肪后，修剪成合适形态，置于鼻背及鼻尖处，修复变薄的皮肤组织，塑造合适的形态。结果本组共36例患者，术后均I期愈合；术后未出现感染、软骨外露及移位等情况，疗效满意。结论自体鼻中隔软骨联合真皮组织移植，可有效修复假体隆鼻引起的并发症，术后外观形态好，值得临床推广。

Objective To explore the therapeutic technique and effect of autologous septal cartilage and dermal tissue on implanted nasal augmentation. Methods A clinical study was performed on 36 cases of nasal augmentation with solid silicone prosthesis implant who suffered from skin thinning or prosthesis exposure at the nasal tip. The silicone prosthesis was taken out from the open approach of columella incision, and comprehen- sive rhinoplasty was performed with autologous septal cartilage for the cover of nasal tip, and harvested and shaved sciatic dermal tissue for the reconstruction of thinning soft tissue. Results All 36 cases healed primari- ly without infection and cartilage exposure or shifting. Conclusion Comprehensive rhinoplasty with autologous septal cartilage and dermal tissue is an effective approach for the repair of complications of implanted nasal aug- mentation, which is worth spreading in clinic.