改良耳软骨鼻中隔延伸移植物支架在鼻综合整形术的效果

Effect of modified auricle cartilage nasal septum extension stent on rhinoplasty

目的介绍一种改良的耳软骨鼻中隔延伸移植物(SEG)支架技术,并探讨在鼻整形术应用的效果.方法2019年3月至2020年2月,广东东莞南城西妃医疗美容门诊部行鼻整形术116例患者,女102例,男14例,年龄18~42岁,平均23.7岁.采取双侧耳甲艇软骨进行贝壳对位缝合和燕尾改形,制成SEG搭建鼻头软骨支架,鼻梁采用膨体或硅胶假体,进行鼻综合整形术,随访6~18个月,观察鼻长、鼻突出度、鼻尖、鼻唇角形态评估手术效果.结果116例患者术后即刻均获满意的外形效果,鼻背延长3~6 mm,鼻突出度延长2~5 mm.随访6~18个月,效果稳定(回缩0.5~1.5 mm);鼻尖、鼻唇角形态满意,皮肤色泽正常.耳软骨供区无畸形,瘢痕不明显.结论改良耳软骨SEG支架具有良好的支撑力和稳定性,不仅对于初鼻之轻中度的短鼻延长、鼻突出度延长有较好效果,对于初鼻之重度短鼻和挛缩不严重的二次鼻整形也有明显改善效果.

Objective To introduce a modified stent technique of nasal septal extension graft(SEG)with auricle cartilage,and to explore its effect on rhinoplasty.Methods For 116 patients that underwent rhinoplasty,the cartilage of bilateral auricula was sutured with shell alignment and the dovetail was modified to prepare SEG stent;PTFE or silicone prosthesis was used for nasal dorsal graft.The patients were follow up for 6-18 months after surgery.A number of indicators including length of nose,tip projection,nasal tip and nasolabial angle morphology were used to assess surgical outcomes.Results The 116 patients obtained satisfactory appearance immediately after operation.Length of nasal extension was 3-6 mm,tip projection was extended by 2-5 mm.Following up for 6-18 months showed stable effect(0.5-1.5 mm retraction)and satisfactory nose tip and nasolabial angle.The skin color was normal.No deformity occured in the ear cartilage donor area existed with no obvious scar.Conclusions The modified SEG stent of auricle cartilage has good support and stability.It has a good effect on the slight and moderate extension of the short nose.In addition,the elevation of the nasal tip and the severe short nose of the first rhinoplasty and secondary rhinoplasty with mild contracture are also improved.