单侧唇裂术后继发鼻畸形伴鼻中隔高位偏曲的同期整复

Correction of secondary nasal deformity combining with upper nasal septum deviation after operation of unilateral cleft lip

目的 观察并探讨单侧唇裂继发鼻畸形伴鼻中隔高位（筛骨垂直板）偏曲同期整复术的临床效果.方法 采取跨鼻小柱鼻翼软骨边缘切口,充分游离移位的组织并将其复位,同时行鼻中隔偏曲矫正术.在传统切除鼻中隔软骨偏曲部分及矫正犁骨沟偏斜的基础上,凿除偏曲的筛骨垂直板部分,并利用所取鼻中隔软骨重建鼻尖支架.结果 本组共30例患者.经1～12个月随访,所有患者鼻外形明显改善,鼻小柱居中,两侧鼻孔大小基本相等,偏曲鼻中隔软骨得到矫正,鼻塞、头痛等症状均得到明显改善.结论 单侧唇裂术后继发鼻畸形伴鼻中隔高位偏曲同期整复术,即通过矫正鼻中隔软骨与硬骨偏曲,从而较彻底地解决了鼻中隔偏曲问题;又通过合理利用所取鼻中隔软骨重建鼻尖支架,改善了鼻尖美学形态,是一种值得推广的手术方式.

Objective To explore and observe the clinical effects of correction of secondary nasal deformity combining with upper nasal septum deviation after operation of unilateral cleft lip.Methods The incision over columella in the edge of nasal alar cartilage was adopted,complete dissection was performed to replace the displaced tissue and the correction of nasal septum deviation was also made simultaneously.Based on traditional excision of deviated nasal septal cartilage and correction of vomerine groove deviation,deviated perpendicular plate of ethmoid bone was removed and the harvested nasal septal cartilage was applied to reconstruct the stand of nasal tip.Results Followed-up on 30 cases was performed for 1 to 12 months,all patients were satisfied with the improved nasal contour,the centered nasal columella,the symmetrically bilateral nostrils and corrected nasal septal cartilage.The symptoms,like nasal congestion and headache,were also improved.Conclusion The procedure of correcting secondary nasal deformity combining with upper nasal septum deviation can not only solve completely the problem of nasal septum deviation by correcting deviation of nasal septum cartilage and bone,but also improve the aesthetics shape of the nasal tip by applying the harvested nasal septal cartilage to reconstruct the stand of nasal tip,which made the double benefits,aesthetics and function were both improved.So it is an effective method to correct the nasal deformities after the operation of unilateral cleft lip.And it is worth popularizing.