肋软骨移植联合鼻软骨黏膜瓣法修复单侧唇裂术后鼻畸形

Repair of secondary nasal deformity after the unilateral cleft lip operation by costal cartilage graft and mucosal flap of nasal cartilages

目的 探讨肋软骨移植联合鼻软骨黏膜瓣法修复单侧唇裂术后鼻畸形的方法及疗效.方法 首先将患侧鼻翼基底彻底松解后植入肋软骨,以抬高患侧鼻翼,再将患侧塌陷的鼻翼组织做彻底解剖,于鼻前庭衬里处设计软骨黏膜瓣,抬高鼻翼.鼻中隔充分游离显露后植入肋软骨,以支撑患侧鼻翼同时加强鼻小柱对鼻尖部位的支撑作用.结果 本组共42例患者,随访3～12个月,术后鼻部畸形均有不同程度地改善,患者均较满意.结论 采用肋软骨移植联合鼻软骨黏膜瓣法修复单侧唇裂术后鼻畸形,具有以下优点：可切取的肋软骨量充足,即可以抬高患侧凹陷的鼻翼基底,又可以支撑患侧鼻翼及鼻头,必要时还可以抬高鼻背;肋软骨移植为自体组织移植,无排异,感染率低;对鼻部畸形的鼻翼软骨重新解剖,并利用皮瓣原理复位,有效地矫正了鼻畸形.因此,肋软骨移植联合鼻软骨黏膜瓣法是修复单侧唇裂术后鼻畸形的理想方法.

Objective To study the method and effect of costal cartilage graft and mucosal flap of nasal cartilages on nasal deformity after the unilateral cleft lip operation.Methods Base of nasal ala on the affected side was released completely and then the costal cartilage was grafted to raising the base.The pedicled cartilage mucosal flap was used for raise alar.After dissociation and exposure of nasal septum,the costal cartilage was grafted to support the nasal ala and enhance the stand to the nasal tip by nasal columella.Results All the patients were followed up for 3 to 12 months,All patients themselves were very satisfied with the significantly improved nasal deformities.Conclusion Costal cartilage graft and mucosal flap of nasal cartilages for repair of nasal deformity after the unilateral cleft lip operation have these advantages,such as：Firstly,the costal cartilage was sufficient to raise the base and support the nasal tip; Secondly,Costal cartilage graft was autologous tissue transplantation with non rejection and low infection; Thirdly,the flaps principle was used to improve nasal deformity,so costal cartilage graft and nasal chondroplasty were an ideal method to improve nasal deformity.