游离皮片或耳郭复合组织移植矫正鼻翼缘退缩的效果

Application of free skin graft or auricle composite tissue in the correction of nasal flange retraction

目的:探讨用游离皮片或耳郭复合组织移植矫正鼻翼缘退缩的临床效果及应用价值。方法:2019年8月至2023年1月,上海联合丽格医疗美容门诊部接诊矫正鼻翼退缩患者45例,男7例、女38例;年龄18~46岁,平均26.6岁。所有患者均有不同程度因鼻翼衬里不足导致的鼻翼缘后缩,退缩2~5 mm,平均退缩3.3 mm。直接用耳郭复合组织游离移植矫正单纯鼻翼缘退缩11例,其余34例患者术中用鼻翼缘软骨移植+游离皮片移植方式进行矫正。结果:随访2~18个月,41例患者效果满意,无明显并发症。2例患者出现游离皮片部分坏死,1例患者出现耳郭复合组织瓣缺血坏死,1例患者出现游离皮片坏死。除上述并发症患者外,3例患者反馈鼻翼退缩矫正未达预期效果,但对手术效果满意,可能为皮片挛缩等因素导致。经随访统计,本组患者共41例对效果满意,总体满意度达91.12%。结论:游离皮片或耳郭复合组织移植矫正鼻翼缘退缩,具有操作简单、适应证广、疗效确切等优点,值得临床应用。

Objective To investigate the clinical effect and application value of free skin or auricle composite tissue transplantation in the correction of nasal alar retraction.Methods From August 2019 to January 2023,a total of 45 patients with nasal retraction(7 males and 38 females)were treated in Shanghai United Regal Medical Cosmetology Hospital.Age ranged from 18 to 46 years,with a mean of 26.6 years.All patients had retroalar margin retraction caused by insufficient alar lining to varying degrees,with a retraction distance between 2-5 mm,with an average retraction distance of 3.3 mm.11 cases of nasal flange retraction were corrected by free transplantation of composite tissue of auricle directly.The remaining 34 patients were corrected by alar border cartilage graft and free skin graft.Results During 2-18 months of follow-up,41 patients had satisfactory results and no obvious complications.Partial necrosis of free skin was observed in 2 patients,ischemic necrosis of complex flap of auricle was observed in 1 patient,and necrosis of free skin was observed in 1 patient.In addition to the above complications,3 patients reported that the correction of alar retraction did not achieve the expected effect,but indicated that they were satisfied with the surgical effect,which was considered to be caused by skin contracture and other factors.The overall satisfaction rate of all patients was 91.1%.After follow-up and statistics,41 patients in this group were satisfied with the results,with an overall satisfaction rate of 91.12%.Conclusions The application of free skin graft(or auricle composite tissue)to correct nasal alar retraction has the advantages of simple operation,wide indications and accurate efficacy,and is worthy of clinical promotion.