内切口鼻尖缩小术中强化鼻翼沟成形的临床效果

Clinical efficacy of strengthening alar groove plasty in nasal tip reduction through internal incision

目的探讨经内切口鼻尖缩小联合外固定的方法，以及小夹板外固定加强双侧鼻翼沟成形的临床效果。方法经双侧鼻前庭切口，分离暴露鼻翼软骨和穹窿间脂肪垫，切除脂肪垫和部分肥大过宽的鼻翼软骨外侧脚。缝合切口后，在组织切除的基础上用塑料小夹板在鼻尖两侧鼻翼沟处缝合外固定1周，以达到加强鼻翼沟成形的效果。结果术后143例随访超过6个月，鼻尖缩小效果好，鼻翼沟成形明显，左右鼻翼沟间距从术前（28．23±3．31）mm缩窄到术后（23．72±2．65）mm，鼻尖鼻翼夹角从术前（104．02±9．57）°减小到术后（87．78±6．98）°，差异有统计学意义（P〈0．05）。有6例鼻翼左右轻度不对称，1例患者因夹板边缘0．6cm的表皮破损而遗留细小瘢痕。结论在内切口鼻尖缩小的基础上，缝合小夹板进行外固加强鼻翼沟成形的方法，简单有效，容易掌握。

Objective To investigate the effects of nasal tip reduction with inner incision combined with external fixation, namely, to evaluate the formation of bilateral alar groove which is enhanced by external fixation with small splints, after removing interdomal fat pad as well as adjusting alar cartilage to reduce nasal tip. Methods Alar cartilage and interdomal fat pad were exposed via the bilateral nasal vestibular incision to remove fat pad and part of enlarged lateral foot of Mar cartilage. After suture of incision, based on the tissue removal, plastic splint was used for external fixation of bilateral nasal tip and alar groove for one week, to enhance the formation of Mar groove. Results A total of 143 patients were followed up for more than 6 months after operation. Photographs taken before and after operation were compared, suggesting obviously smaller nasal tip and significant alar groove. Left and right alar groove space was decreased from preoperative （28.23±3.31） mm to post- operative （23.72±2.65） mm, and nasal tip-alar angle was decreased from （104.02±9.57）°to （87.78±6.98）°, with statistical significance （P 〈0.05）. Slightly asymmetric nasal Mars were found in 6 patients during follow-up examination, while tiny scars caused by splints （at 0.6 cm from the edge of splints） were found in 1 patient. Conclusions On the basis of nasal tip reduction with inner incision, the method of suture with small splints combined with external fixation is simple, effective and available.