应用自体肋软骨治疗短鼻畸形的临床效果

Clinical efficacy of short nose lengthening by using autologous costal cartilage

目的探讨自体肋软骨短鼻延长术治疗短鼻畸形的临床效果。方法对253例短鼻畸形采用自体肋软骨行双侧延伸型鼻中隔撑开移植物（ESG）和鼻小柱支撑移植物（CS）移植的方法，增加了鼻背长度及鼻尖部支撑力，同时根据具体情况行肋软骨鼻背抬高、鼻翼缘下推、鼻尖修饰。结果253例短鼻美容就医者对术后形态满意，鼻背延长，鼻尖上旋纠正，鼻小柱～小叶角正常。随访6～17个月，鼻背长度及形态稳定，2例使用盾形移植物者出现了鼻尖下降，4例出现鼻背移植物偏曲，经手术纠正后亦获得了满意的效果，无感染、无软骨外露等情况出现。结论自体肋软骨矫正短鼻可获得稳定的鼻部重建支架，且能同时应用在鼻部其他亚单位的形态矫正，达到综合改善鼻部形态和功能的效果。

Objective To explore the clinical efficacy of applying autologous costal cartilage in lengthening the short nose. Methods Bilateral extended spreader grafts （ESG） and columellar strut grafts were performed by using autologous costal cartilage in 253 patients with short nose, which increased nasal dorsal length and the support force of nasal tip; meanwhile, autologous costal cartilage was used for dorsal augmentation, Mar rim retraction, and nasal tip modification. Results A total of 253 patients with short nose were satisfied with postoperative morphology, which presented elongated nasal dorsum, correction of nasal tip topspin, and normal nasal columella-lobular angle. 6 months to 17 months follow-up was conducted, and nasal length and morphology showed stable, while 2 cases presented slight nasal tip decreasing, 4 cases presented dorsal grafts warping; after revision surgery, the 6 patients had also got satisfactory results. Conclusions Correction of short nose using autologous costal cartilage can result in more stable nasal reconstruction structure, and can be used for the shape correction of other suhunits of the nose, achieving at the comprehensive improvement of nasal morphology and functions.