自体肋软骨联合膨体矫正单侧唇裂术后继发鼻部畸形

Correction of secondary nasal deformities after unilateral cleft lip repair with autologous costal cartilage and expanded polytetrafluoroethylene

目的探讨自体肋软骨(autologous costal cartilage,ACC)联合膨体聚四氟乙烯(expanded polytetrafluoroethylene,e-PTFE)移植鼻整形术在单侧唇裂继发鼻畸形整复中的治疗效果。方法自2018年7月至2021年7月,中国医学科学院北京协和医学院整形外科医院唇腭裂整形科对19例单侧唇裂继发鼻畸形患者采用ACC联合e-PTFE行隆鼻术,切取右侧第7或第8肋软骨拐角的一段,根据鼻背需要抬高的程度雕刻e-PTFE,将其作为鼻背盖板移植物置于鼻背筋膜下;雕刻ACC(鼻中隔成对撑开延伸移植物、鼻小柱支撑移植物、鼻尖盖板移植物、鼻翼缘移植物)用于抬高鼻尖、延长鼻小柱。结果19例患者获随访6~30个月,术后鼻外形改善明显,鼻尖形态良好,移植物无排出、感染、弯曲。结论ACC联合e-PTFE应用于单侧唇裂术后继发鼻畸形患者,可上抬鼻尖、延长鼻小柱和抬高鼻背,疗效确切、安全性较好、远期效果较好,患者满意度较高,具有良好的临床应用价值。

Objective TTo explore the therapeutic effect of autologous costal cartilage(ACC)and expanded polytetrafluoroethylene(e-PTFE)nasal plasty in the treatment of secondary nasal deformities of unilateral cleft lip.Methods Nineteen patients with nasal deformity after unilateral cleft lip repair were treated from July 2018 to July 2021.During the operation,a segment of the right 7th or 8th costal cartilage corner was cut,carved and formed.Then the costal cartilage was implanted into the nasal tip and nasal columella,while the back of the nose is raised with e-PTFE.Results Nineteen cases were followed up for 6 to 30 months.The graft had no exposure,discharge,infection,or curvature.The appearance was good and the patients were satisfied.Conclusion Autologous costal cartilage combined with e-PTFE has a definite therapeutic effect on patients with secondary nasal deformities after unilateral cleft lip repair.