基于结构式鼻整形亚单位原理修复单侧唇裂继发鼻畸形的临床回顾性研究

A clinical retrospective study on the secondary nasal deformity of unilateral cleft lip based on the structural rhinoplasty subunit repair principle

目的探讨基于结构式鼻整形亚单位原理进行自体肋软骨联合膨体聚四氟乙烯(expanded polytetrafluoroethylene,e-PTFE)在单侧唇裂继发鼻畸形整复中的治疗效果。方法自2016年8月至2022年12月,北京大学第三医院成形外科收治25例单侧唇裂继发鼻畸形患者,采用自体肋软骨联合PTFE矫正单侧唇裂继发鼻畸形。采用Face-Q量表评估患者手术前后鼻部美学的满意度以及鼻塞症状评估(nasal obstruction symptom evaluation,NOSE)量表评估术后鼻塞通气功能情况,同时记录患者术后并发症的发生情况。结果25例患者术后切口均一期愈合。术后获随访3个月至6年,鼻部形态良好,鼻尖及鼻小柱基本居中,鼻背较术前增高,鼻翼塌陷较术前减轻,双侧鼻孔间差异缩小,患侧鼻基底较术前抬高,无感染、鼻中隔偏曲、移植物外露等并发症发生。Face-Q量表评估结果提示,患者术后鼻部美学满意度明显提升;NOSE量表结果表明,患者通气功能在术后得到改善,评分差异具有统计学意义(P<0.05)。结论基于结构式鼻整形亚单位原理采用自体肋软骨联合e-PTFE修复单侧唇裂继发鼻畸形可以获得良好的术后效果。

Objective To explore the therapeutic effect of autogenous costal cartilage combined with expanded polytetrafluoroethylene(e-PTFE)in the repair of secondary nasal deformities of unilateral cleft lip based on the principle of structural nasal plastic subunit repair.Methods From August 2016 to December 2022,25 patients with nasal deformities secondary to unilateral cleft lip were treated.Nasal deformity secondary to unilateral cleft was corrected lip with autologous costal cartilage combined with Polytetrafluoroethylene.The Face-Q scale was used to evaluate patients'satisfaction with nasal aesthetics before and after surgery,and the Nasal Obstruction Symptom Evaluation(NOSE)scale was used to evaluate the nasal obstruction ventilation function after surgery,and the postoperative complications and incidence rates of patients were recorded.Results All incisions healed by first intention after operation,and no complications such as acute infection occurred.All 25 patients during the follow-up period,the shape of the nose remained good,the tip of the nose and the columella were basically in the middle,the dorsum of the nose was raised,the collapse of the nasal alar was reduced,and the difference between the bilateral nostrils was reduced.No cartilage exposure,infection,etc.occurred.Face-Q suggested that patients'satisfaction with postoperative nasal aesthetics was significantly improved,and the NOSE scale proved that the ventilation function of patients was improved after surgery,and the scores were significantly different.Conclusion Autogenous costal cartilage combined with e-PTFE can achieve good postoperative results in the correction of nasal deformity secondary to unilateral cleft lip.