颅面裂鼻翼畸形综合修复的治疗探讨

Discussion of the surgical method for repairing nasal alar malformations caused by cranial-facial cleft

目的探讨利用原位及邻位组织联合自体耳甲腔软骨对颅面裂患儿鼻翼畸形进行综合修复的临床效果。方法对颅面裂伴鼻翼畸形的患儿采用鼻部残留软组织、邻位皮瓣以及自体软骨游离移植行综合修复治疗。结果本组共4例患儿,术后均恢复良好。术后随访6~24个月,患儿及家属对手术效果满意。其中1例患儿鼻尖表现点不佳,局部皮瓣臃肿,拟待青春发育期后行二期皮瓣修薄等手术。结论充分利用鼻部残留软组织、邻近皮瓣和自体软骨,在完全松解复位原位组织的前提下,联合自体软骨或假体置入等综合手术方法,对颅面裂鼻翼畸形修复有良好的疗效。

Objective To explore the effect and methods for reconstructing nasal alar malformation caused by cranial-facial clef through situ and adjacent tissue combined with autologous auricular cartilage transplant. Methods The remaining nasal soft tissue, adjacent flap and autologous cartilage free grafting was used to perform a comprehensive reconstructive surgery. Results There were a total of 4 patients in this research, all of whom were satisfied with the results during 6 to 24 months follow-up period. Among of them, 1 patient needed a secondary surgery to repair the apex nasi after puberty to achieve aesthetic effect because of local bloated flap. Conclusion The reconstructive surgery was performed by sufficient use of nasal soft tissue, adjacent flap and auto-cartilage. A satisfactory result can be achieved for alar malformation caused by cronial-facial cleft.