“十字”形耳软骨支架及鼻翼沟成形在鼻部整形的临床应用

Summary of clinical application of"cruciform"ear cartilage scaffold and alar groove plasty in tip rhinoplasty

目的探讨"十字"形耳软骨支架及鼻翼沟成形在鼻部整形的应用效果。方法选取自2014年1月至2017年12月就诊于中国医学科学院北京协和医学院整形外科医院整形十六科37例假体隆鼻术同时行"十字"形耳软骨支架及鼻翼沟成形术患者,术中先将假体置入鼻背,再将自体耳软骨交叠形成"十字"形软骨支架行鼻尖成形术;鼻翼沟成形术采用局部皮下组织修薄,油纱卷外部加压并通过鼻翼沟贯穿缝合固定4~7 d。结果所有患者术后鼻部外形均明显改善。随访6~24个月,未出现明显假体歪斜、外露、感染、局部皮肤破溃等并发症,手术效果较好。结论应用"十字"形耳软骨支架联合鼻翼沟成形行鼻部整形,可有效强化鼻翼沟轮廓、加强鼻尖点的表现、减少硅胶假体的早期位移,术后形态较好。

of clinical application of"cruciform"ear cartilage scaffold and alar groove plasty in tip rhinoplasty DU Le,JIN Xiao-lei,ZONG Xian-lei,SONG Guo-dong,WU Rong-wei.(The 16 th Department of Plastic and Reconstructive Surgery,Plastic Surgery Hospital,Chinese Academy of Medical Sciences,Beijing 100144,China)Corresponding author:JIN Xiao-lei,Email:jinyuyizxyy@126.com【Abstract】Objective To explore the clinical application of"cruciform"ear cartilage scaffold and alar groove plasty in tip rhinoplasty.Methods In a retrospective study from January 2014 to December 2017,37 patients underwent dorsum and tip augmentation with alar grove plasty using the technique.All patients underwent primary augmentation rhinoplasty or a second revision following a simple silicone implant to the dorsum.During the operation,a silicone implant was used for dorsum augmentation.Autologous ear cartilage was harvested and dissected to form a"cruciform"cartilage scafford for tip augmentation.The subcutaneous tissue under desired alar groove area was properly thinned to allow reattachment under percutaneous trans-fixation for 4 to 7 days.Results All patients the postoperative results were mainly satisfying with tip augmentation and a better-defined alar grove.Postoperative courses were uncomplicated during a 6 to24 months follow-up without tip extrusion,infection,and graft shifting.Conclusion The combined technique is safe and effective in nasal dorsum and tip augmentation with alar grove improvement.It defines the tip and the alar groove area while minimizing the risk of early stage graft shifting in a relatively simple and less invasive way,postoperative appearance is better than before.