高密度多孔聚乙烯联合耳软骨移植在鼻整形中的应用及美学效果观察

Application and Aesthetic Effect of High-density Porous Polyethylene Combined with Auricular Cartilage Transplantation in Rhinoplasty

目的:探究高密度多孔聚乙烯联合耳软骨移植在鼻整形中的应用及美学效果。方法:笔者2019年1月-2021年1月,对38例患者采用高密度多孔聚乙烯联合耳软骨移植行鼻整形术。根据患者实际情况,选择高密度多孔聚乙烯作为填充物进行鼻小柱延长,自体耳软骨作为鼻尖覆盖,硅胶或膨体作为鼻背修饰物。分析患者鼻整形效果,采用数字化面部扫描技术测量患者鼻长、鼻尖高度、鼻唇角和左右鼻尖顶点间距,计算术后鼻唇角、鼻尖高度和鼻尖距的美学达标率,FACE-Q量表评估患者面部总体外观满意度、心理健康和社会功能变化;随访12个月,记录术后并发症发生情况。结果:本组38例患者均顺利完成手术,术后切口均I期愈合,无明显瘢痕,耳软骨供区无明显外观改变;鼻小柱延长效果明显,鼻尖长度和高度维持稳定;鼻背平直,鼻根形态过渡自然;鼻拱对称,鼻尖触感自然,效果满意。术后,患者的鼻长、鼻尖高度均较术前增大,鼻唇角和左右鼻尖顶点间距较术前下降(P<0.05);患者的鼻唇角、鼻尖高度和鼻尖距美学达标率分别为94.73%(36/38)、92.11%(35/38)和94.73%(36/38)。术后患者的面部总体外观满意度、心理健康和社会功能评分均较术前明显升高(P<0.05)。随访期间,1例患者术后1个月出现鼻头红肿,经抗炎治疗后恢复;1例患者术后1个月自觉鼻孔不对称,术后3个月自行改善,并发症发生率为5.26%(2/38)。结论:高密度多孔聚乙烯联合耳软骨移植用于鼻整形具有较好的美学效果,能有效改善鼻轮廓外形,提高患者总体外观满意度、心理健康和社会功能水平,且并发症发生率低,安全可靠。

Objective To explore the application and aesthetic effect of high-density porous polyethylene combined with auricular cartilage transplantation in rhinoplasty. Methods A total of 38 patients underwent rhinoplasty with high-density porous polyethylene combined with auricular cartilage transplantation from January 2019 to January 2021.According to the patients’ actual conditions,high-density porous polyethylene was used as the filler for nasal columella extension,autologous auricular cartilage was used for nasal tip covering,and silicone or expanded polytetrafluoroethylene was used for nasal dorsum modification.The rhinoplasty effect was analyzed.The nasal length,nasal tip height,nasolabial angle and the distance between the left and right nasal tips were measured by digital facial scanning technology.The aesthetic control rates of postoperative nasolabial angle,nasal tip height and nasal tip distance were calculated.The overall satisfaction with facial appearance,and changes of mental health and social function were evaluated with the FACE-Q.All were followed up for 12 months to record the occurrence of postoperative complications. Results All the 38 patients successfully completed the surgery,and incision reached primary healing after operation.No obvious scars or obvious appearance changes were observed at auricular cartilage donor site.The extension effect of nasal columella was significant,length and height of nasal tip were stable.The nasal dorsum was straight,and transition of nasal root morphology was natural.The nasal arches were symmetrical,and feeling of nasal tip was natural,with satisfactory effect.After surgery,nasal length and nasal tip height were increased,while nasolabial angle and the distance between the left and right nasal tips were decreased(P<0.05).The aesthetic control rates of nasolabial angle,nasal tip height and nasal tip distance were 94.73%(36/38),92.11%(35/38) and 94.73%(36/38),respectively.After surgery,the scores for overall satisfaction with facial appearance,mental health and social function were significantly increased(P<0.05).During follow-up,there was 1 patient with nasal swelling at 1 month after surgery who recovered after anti-inflammatory treatment,and 1 patient with asymmetric nostrils which was improved at 3 months after operation.The incidence of complications was 5.26%(2/38). Conclusion High-density porous polyethylene combined with auricular cartilage transplantation can achieve good aesthetic effect in rhinoplasty,which can effectively improve the morphology of nasal profile,improve the patients’ satisfaction with facial appearance,mental health and social function,with a low incidence of complications.Besides,it is safe and reliable.