筛骨垂直板的应用对功能性鼻整形术就医者美学参数的影响

Effects of Perpendicular Plate of Ethmoid Bone on Aesthetic Parameters in Patients Undergoing Functional Rhinoplasty

目的:分析筛骨垂直板的应用对功能性鼻整形术就医者美学参数的影响。方法:选取2016年2月-2021年2月于笔者医院拟行鼻综合整形术的90例短鼻畸形就医者为研究对象,分离并测量鼻中隔软骨,若鼻中隔软骨较小者,采用鼻中隔软骨结合筛骨垂直板进行鼻中隔延伸移植鼻整形术,记录出院时切口愈合分级,术后随访12个月,观察术后并发症及就医者满意度,并在术前及术后6个月测量美学参数。结果:出院时就医者Ⅰ级愈合率为66.67%,Ⅱ级愈合率为28.89%,Ⅲ级愈合率为4.44%。术后随访1~12个月,2例就医者在术后1个月发生鼻背移植偏斜,经手术修复后矫正;术后6个月后,就医者短鼻畸形均得到改善,且就医者的鼻长、理想鼻长、鼻尖高度、鼻尖突出度、额鼻角、鼻唇角均高于术前(P<0.05)。术后随访12个月,均未发生鼻中隔血肿、鼻中隔穿孔、鼻通气功能障碍、感染及嗅觉减退等并发症。术后6个月,就医者对鼻形、鼻尖、鼻尖旋转度、鼻孔直径满意度评分均高于术前(P<0.05)。结论:在功能性鼻整形术中应用筛骨垂直板进行支撑塑形,美学效果较佳,满意度较高,且安全性较高,值得推广。

Objective To analyze the effects of perpendicular plate of ethmoid bone on aesthetic parameters in patients undergoing functional rhinoplasty.Methods A total of 90 patients with brachyrhinia deformity undergoing elective comprehensive rhinoplasty in the author’s hospital were enrolled as the research objects between February 2016 and February 2021.The autologous septal cartilages were isolated for measurement.For patients with small nasal septal cartilages,complex of septal cartilages and perpendicular plate of ethmoid bone was applied to conduct comprehensive rhinoplasty with nasal septum extension and transplant.The wound healing grade at discharge was recorded.All were followed up for 12 months after surgery to observe postoperative complications and satisfaction of beauty seekers.Before and at 6 months after surgery,aesthetic parameters were measured.Results At discharge,the gradeⅠhealing rate was 66.67%,gradeⅡhealing rate was 28.89%,and grade Ⅲ healing rate was 4.44%.With 1-12 months of postoperative follow-up,there were 2 cases with deviation of nasal dorsal transplantation at 1 month after surgery,which was eff ectively corrected after surgical re-fi xation and repair.At 6 months after surgery,brachyrhinia deformity was improved.nose length,ideal nose length,height of nose tip,protrusion of nose tip,nasofrontal angle and nasolabial angle were increased(P<0.05).During 12 months of postoperative follow-up,there were no complications such as nasal septal hematoma,nasal septal perforation,nasal ventilation dysfunction,infection and hyposmia.At 6 months after operation,patients'satisfaction scores on nasal shape,tip,tip rotation and nostril diameter were higher than those before operation(P<0.05).Conclusion The application of perpendicular plate of ethmoid bone for support and shaping in functional rhinoplasty has good aesthetic effect,high satisfaction of beauty seekers,with higher safety.