鼻孔基底与鼻翼基底联合切除矫正鼻翼肥大

Combined resection of nostril floor and alar base for treatment of alar hypertrophy

目的探讨鼻孔基底与鼻翼基底联合切除矫正鼻翼肥大的疗效。方法2016年6月至2018年12月,空军军医大学西京医院整形外科对鼻翼肥大的患者32例,女29例,男3例;年龄18~40岁。用鼻孔基底与鼻翼基底联合切除的方法进行矫治,切除鼻翼基底时保留小叶前庭皮肤,切除鼻孔基底三角形皮肤,在肌肉浅层对鼻翼皮瓣进行松解后向内收缝合。其中18例同时做了鼻尖、鼻背塑形,14例行单纯行鼻翼缩小术。术前后测量鼻翼最膨出点间距以及患者的满意度来评估手术效果。结果32例患者随访6个月,手术切口全部一期愈合,无出血及感染,鼻孔形态良好,未产生鼻槛切迹,瘢痕不明显。术前与术后6个月比较,鼻翼膨出点间距自(39.4±1.1)mm减少到(36.6±0.8)mm,差异有统计学意义(t=15.7,P<0.05),满意率90.6%。结论鼻孔基底与鼻翼基底联合切除矫正鼻翼肥大效果满意,可作为矫正鼻翼肥大的术式之一。

Objective To explore the clinical effect of combined resection of nostril floor and alar base for alar hypertrophy.Methods Thirty two patients(female:29 cases,male:3 cases;age from 18-40 years)with nasal alar hypertrophy engaged in this study.Vestibular skin was retained when the alar base was excised.After triangular skin excision of nostril floor,the alar flap was released from superficial muscle and moved medially to close the excision defect.18 cases underwent simultaneously tip and dorsum remodeling,while the other 14 cases did just alar plasty.The clinical efficacy was evaluated by pre-and post-operative mesurement of inter alar width and patients'satisfaction survey.Results Patients were followed up for six months.Primary healing was obtained in all the cases,and no postoperative complications such as bleeding or infection occurred,the nostril contour was good,without notching and obvious scar.With the comparison before and six months after surgery,the average inter alar width was reduced from(39.4±1.1)mm to(36.6±0.8)mm(t=15.7,P<0.05),Patients'satisfaction after operation was 90.6%.Conclusions The clinical efficacy of the combined resection of nostril floor and alar base is satisfactory and it could be one of the ways to treat alar hypertrophy.