自体耳甲软骨修复单侧唇裂鼻畸形的效果评价

Evaluation of the effect of repairing unilateral cleft lip nose deformity with autogenous concha cartilage

目的:评价采用自体耳甲软骨移植修复单侧唇裂术后鼻畸形的矫正效果。方法:收集13例单侧唇裂术后鼻畸形患者,采用自体耳甲软骨,同期行鼻中隔偏曲矫正术。分别拍摄术前、术后5天、术后1个月、术后6个月的下颌抬颏位照,采用主观评价与客观测量方法,评估鼻部形态。采用SPSS 21.0软件包对数据进行统计学分析。结果:术前与术后5天鼻部形态有显著差异(P=0.000),术后5天与术后1个月、术后6个月间无显著差异(P=0.110,0.053)。术前与术后5天、术后1个月、术后6个月间的鼻尖对称率无显著差异(P=0.051,0.136,0.204),术前与术后5天的鼻底、鼻小柱、鼻翼外凸角、鼻翼基脚内倾角对称率有显著差异(P=0.000,0.000,0.000,0.000);术后5天与术后1个月、术后6个月间上述4个指标对称率均无显著差异(P>0.05)。结论:采用自体耳甲软骨修复单侧唇裂术后鼻畸形,可有效改善术后鼻底、鼻小柱、鼻翼对称性,术后半年效果稳定。

PURPOSE:To explore the effect of nasal deformity correction after unilateral cleft lip repair with autogenous concha cartilage transplantation.METHODS:Thirteen patients with nasal deformity after unilateral cleft lip surgery were collected,who were treated with autogenous concha cartilage and nasal septum deviation correction at the same time.Their chin-lifting photos were taken before operation,five days,one month and six months after operation.The nasal morphology was evaluated by subjective evaluation and objective measurement,and statistical analysis was performed using SPSS 21.0software package.RESULTS:Subjective evaluation showed that there was significant difference in nasal morphology between prior to operation and 5 days postoperatively(P=0.000),but there was no significant difference between 5 days postoperatively and 1 month and 6 months postoperatively(P=0.110,0.053).In objective measurement,there was no significant difference in the symmetry rate of nasal tip between prior to operation and 5 days,1 month and 6 months after operation(P =0.051,0.136,0.204),but there was significant difference in the symmetry rate of nasal base,nasal columella,ex-tranasal convex angle and nasal alar base inclination angle between prior to operation and 5 days postoperatively( P=0.000,0.000,0.000,0.000).However,there was no significant difference in symmetry rate of the above four indexes between 5days after operation and 1 month and 6 months after operation(P>0.05).CONCLUSIONS:Autogenous concha cartilage transplantation can effectively improve the symmetry of nasal floor,columella and alar after operation,and the effect is stable half a year after operation.