单侧耳软骨结合膨体聚四氟乙烯组成L形支架的鼻整形术

L-shaped Stent Consisting of Unilateral Auricular Cartilage and Expanded PTFE in Rhinoplasty

目的:探讨单侧耳软骨结合膨体聚四氟乙烯组成L形支架在隆鼻整形术中的临床效果。方法:回顾性分析笔者医院2018年8月-2022年2月收治的258例应用该术式的就医者。切取单侧整块耳甲软骨,切取部分耳甲艇软骨作为鼻尖帽状移植物,将剩余耳甲软骨纵向切开,对折后缝合作为L形支架短臂。将膨体聚四氟乙烯材料雕刻成适合就医者鼻背基础的柳叶状移植物,尾侧端雕刻出凹槽作为L形支架长臂。分离出合适的鼻背、鼻小柱腔隙,植入鼻背假体及对折缝合后的耳软骨,接合处修剪缝合固定形成L形支架。鼻尖放置帽状移植物塑形出鼻尖的美学表现点。结果:本组258例就医者,随访3~24个月,255例满意,鼻部外形自然美观。1例术后8个月出现慢性感染、2例12个月出现鼻尖皮肤变薄耳软骨显形,均行2次手术矫正。结论:通过单侧耳软骨结合膨体聚四氟乙烯组成L形支架的隆鼻整形术能有效改善鼻尖形态,并保持鼻尖外形的稳定。

Objective To discuss the clinical eff ect of the L-shaped stent consisting of unilateral auricular cartilage and expanded PTFE in tip rhinoplasty.Methods A total of 258 patients treated in the auth0r’s hospital from August 2018 to February 2022 who underwent this operation were selected.A whole piece of unilateral concha cartilage was cut,part of the cymba conchae cartilage was cut and used as the cap-shaped graft of the tip of the nose,and the remaining concha cartilage was cut longitudinally,folded in the middle,sutured,and used as a short arm of the L-shaped stent.The expanded PTFE material was carved into a willow leaf-like graft suitable for the base of the nasal dorsum of the patient,and a groove was carved at the caudal end and used as the long arm of the L-shaped stent.Appropriate nasal dorsum and nasal columella cavity were separated,the nasal dorsum prosthesis and auricular cartilage folded in the middle and sutured were implanted,and an L-shaped stent was formed by trimming and suturing the junction.A cap-shaped graft was placed on the tip of the nose to shape the aesthetic expression point of the tip of the nose.Results The 258 cases in this group were followed up for 3-24 months,255 of which were satisfied with the natural and beautiful nasal shape.1 case suff ered from chronic infection 8 months after the surgery,and 2 cases had skin thinning at the nasal tip and auricular cartilages emergence 12 months after the surgery,for which 2 operations were underwent for correction.Conclusion Tip rhinoplasty with an L-shaped stent consisting of unilateral auricular cartilage and expanded PTFE can effectively improve the shape of the tip of the nose and maintain stability of the shape of the tip of the nose.