肋软骨鼻支架成形术与硅胶假体隆鼻术矫正Binder综合征面中部凹陷的效果比较

Comparison of costochondral nasal framework reconstruction and silicone graft implantation in improving the midface depression of Binder syndrome

目的 比较肋软骨鼻支架和硅胶假体复合耳廓软骨移植术矫正Binder综合征面中部凹陷的临床效果.方法 临床治疗18例Binder综合征患者,其中采用硅胶假体复合耳廓软骨治疗6例,肋软骨鼻支架成形12例.以MB-Ruler对患者术前、术后侧位像的特征点进行测量,并对所得数据进行统计学分析.结果 硅胶组：面部突出度（含鼻）减小（6.66±2.05）°,鼻尖鼻长比增大0.053±0.015,鼻尖突出率增大（7.07±4.35）％（P＜0.05）,面部突出度（含鼻）、鼻唇角改善不大.肋软骨组：面部突出度（含鼻）减小（11.32±2.27）°,面部突出度（不含鼻）减小（5.96±2.17）°,鼻尖鼻长比增大0.920±0.049,鼻尖突出率增大（11.73±7.53）％,鼻唇角减小（11.71±7.68）°（P＜0.05）.与采用硅胶假体复合耳廓软骨移植术比较,肋软骨鼻支架成形术在增加面中部突出度（含鼻以及不含鼻）及鼻尖鼻长比例方面有更显著效果（P＜0.05）.结论 肋软骨鼻支架成形术更适合于改善Binder综合征患者面中部凹陷,尤其是改善鼻部的形态.

Objective To compare the clinical effects of costal cartilage grafts and silicon with auricular cartilage in correcting the midfacial depression of Binder syndrome.Methods We followed up eighteen cases of Binder syndrome treated in our department between 2008-2015.Silicon with auricular cartilage grafts were applied for six cases,costal cartilage scaffold reconstructed in 12 cases.MB-Ruler software was used for preoperative and postoperative measurement of lateral profile.Data obtained was analyzed statistically.Results Silicone group：Angle of convexity of the face with the nose reduce （6.66 ± 2.05） °,Nasal tip-length quotient increase 0.053 ± 0.015,Tip projection anterior glabellar line quotient increase （7.07 ± 4.35） % （P 〈 0.05）.Costalchondral group：Angle of convexity of the face with the nose decreases（11.32 ±2.27） °,Angle of convexity of the face without the nose decreases （5.96 ± 2.17）°,Nasal tip-length quotient increase 0.920 ± 0.049,Tip projection anterior glabellar line quotient increased （11.73 ±7.53）%,nasolabial angle reduce （11.71 ±7.68）°（P 〈0.05）.Independent samples t test between two groups showed that compared to the silicon,costochondral nasal framework reconstruction can get more significant results in increasing angle of convexity of the face （including nose and without nose） and nasal tip-length quotient （P 〈 0.05）.Conclusions Costochondral nasal framework reconstruction is better suited to improve the midfacial depression of Binder syndrome,especially the nasal outcome.