鼻中隔软骨的不对称软化释放及夹板式移植在软骨性歪鼻畸形中的应用

Asymmetrically tension released of septum cartilage and splint transplantation in correcting deformity of cartilaginous nasal deviation

目的本研究探讨在矫正软骨性歪鼻畸形的手术过程中,对常规的手术方式加以改进,观察远期的复发概率。方法采用经鼻小柱的开放式入路,小心分离鼻中隔软骨,松解其周边的各种纤维连接后,对软骨的两面进行不对称的软化释放,再采用耳廓软骨的夹板式移植加固薄弱的鼻中隔软骨,使得歪鼻畸形中的软骨偏斜部分得到彻底矫正,由于采用了两种对抗回缩的机制,使得远期复发的可能性大为降低,而且直视下的修复提高了修复的精确性,减少穿孔等并发症的风险。结果采用本方法共治疗12例患者,经过约6个月到3年的随访期限,证实效果良好,远期没有复发征象,患者较为满意。结论采用鼻中隔软骨的不对称软化释放及夹板式移植,对软骨性歪鼻畸形的矫正效果良好,值得进一步研究。

Objective This paper aims to discuss how to improve the regular operational techniques in correcting deformity of cartilaginous nasal deviation in order to achieve better result of correction of cartilaginous deviation and reduce recurrence probability in the long term. Method Adopting an open approach of incision on nasal columella, septal cartilage is separated apart and the fber around it is loosened. Both sides of the cartilage is asymmetrically softened and released. Then the vulnerable septal cartilage is reinforced by splint transplantation of auricular cartilage on to it so that the nasal deformity as a result of cartilaginous deviation can be completely corrected. With the use of two kinds of mechanisms against retraction, the recurrence probability in the long term can be largely reduced. Meanwhile, the accuracy of correction under direct vision can be enhanced which will decrease the risks of occurrence of complication such as perforation. Results 12 cases of nasal deformity were treated and followed up for 6 months to 3 years. The result proves to be efective and satisfactory with no evidence of recurrence in the long term. Conclusions By adopting the techniques of asymmetrically softening and releasing the septal cartilage and splint transplantation, good result can be achieved in correcting deformity of cartilaginous nasal deviation. The techniques deserve further study.