耳甲软骨结合耳后浅筋膜移植增加鼻背高度的临床应用

Augmentation rhinoplasty with ear concha cartilage combined postauricular fasia

目的：探讨耳甲软骨结合耳后筋膜移植增加鼻背高度的临床应用。方法：本组21例求美者就诊于2010年6月至2016年1月,均诊断为鼻背部、鼻根部低平。获取一或两侧的耳甲软骨和一侧的耳后筋膜,塑形后的耳甲软骨植入鼻背或鼻根部以增加其高度,筋膜移植减少移植后软骨台阶感的发生率。结果：本组21例求美者术后随访时间6个月~5年,其中4例鼻部侧面出现软骨移植体的台阶和不规则感,1例鼻根部移植的假体出现整体的轮廓感。经过简单的抽吸处理后鼻外形达到可以接受的程度。3例求美者主诉鼻背高度增加不足,未予处理。1例耳甲腔的皮肤因为术后继发血肿而出现皮肤的挛缩,未予处理。通过最长达5年时间的随访,鼻部形态效果稳定,供区的耳廓形态无畸形。结论：该方法在一定适应证的情况下可以取得较好的临床效果。

Objective： To explore the application of ear concha cartilage combined with retroauricualr fascia for augmentation rhinoplasty. Methods： A retrospective case review of 21 consecutive patients（ from June,2010 to January,2016） who were diagnosed as a lower dorsa deformity was conducted. Unileral or bilateral concha cartilage and unilateral retroauricualr fascia were harvested. The sculpted carilages were implanted in the dorsum or nasion.For augmentation rhinoplasty and the grafted fasia reduced the occurance of step deformity from implanted cartilage.Results： All cases were followed up postoperatively in a period between 6 months to 5 years. A side dorsual formities of step deformity and irregulatities were exhibited in 4 cases. Visible cartilage contour was showed in 1 case. Theabove 5 cases were satisfied with the results after treated with a simple thenique. 3 cases were undercorrected and didn’t need to further surgery. Some cases in 5 years’ followed period showed a stable augmentation and the surgical auricule showed no contour deformties. Conclusion： This method can get a better clinical effect in the case of indications.