自体肋软骨联合膨体聚四氟乙烯鼻部综合整形的临床效果

Comprehensive rhinoplasty with costal cartilarge and e-PTFE

目的探讨应用自体肋软骨结合膨体聚四氟乙烯行鼻综合整形手术的方法和效果。方法48例鼻部整形者，均为女性，年龄22～35岁。其中36例为1～3次鼻整形术后修复者，12例为初次鼻整形者。截取3～4cm长第6或7肋软骨，制做鼻小柱支撑移植物、鼻中隔延伸移植物、伞状及盾牌形移植物等，通过鼻尖部的结构移植完成鼻尖部塑形。应用膨体聚四氟乙烯雕刻鼻根部垫高所需的假体并植入。结果经过6～12个月随访，45例获得满意的鼻背及鼻尖美学效果，鼻背轮廓线、鼻尖表现点及鼻尖上区转折明晰；3例出现鼻小柱编斜、鼻孔不对称，术后半年调整鼻小柱支架及鼻孔形态后获得满意效果。均无气胸、无感染、无血肿者，胸壁瘢痕不明显。无膨体感染病例。结论联合应用自体肋软骨和膨体聚四氟乙烯材料来完成鼻部综合整形，取长补短，临床效果好。

Objective To explore the comprehensive approach of rhinoplasty using autologous costal cartilage and e-PTFE, and to observe the outcome and possible complications. Methods A 3- 4 cm long costal cartilage was taken out mostly from the 6th or 7th rib and then divided into several parts and shapes. Structural reconstruction of the nasal tip was then done with these costal cartilage parts. Radix augmentation was conducted with e-PTFE. Results From Jan. 2013 to Sept. 2014, 48 patients were treated with this method, all females, aged 22-35 years. 36 of them had received rhinoplasty before, 12 of them received none. Satisfying aesthetic contouring of the nasal tip and dorsum had been achieved in 45 patients. Deviation of the collumella and nostril asymmetry were found in 3 patients. Among all patients, no such complications as pneumothorax, hemothorax, infection, or hemotoma were observed. The scar on the donor site was not obvious. Conclusions Costal cartilage is sufficient, supportive and easily shapable, when applied to the structural reconstruction of the nasal tip, which can meet the demands of patients who prefer more outstanding and delicate nasal tip contouring.