自体肋软骨皮质改善鼻尖形态的效果

Effects of costal cartilage cortex on nasal tip contour improvement

目的探讨自体肋软骨皮质作为鼻尖支撑及修饰移植物在改善鼻尖形态中的效果。方法2020年6月至2021年6月,北京米扬丽格医疗美容门诊部美容外科要求实施鼻尖成形术患者116例,男26例、女90例,年龄20~45(27±7)岁,用CT辅助检查并切取肋软骨,将肋软骨皮质制作呈"板条状"及"帽状"移植物塑造鼻尖形态,聚四氟乙烯膨体或硅胶假体抬高鼻背行鼻综合整形术。结果113例鼻尖形态稳定,均获得满意效果;仅3例患者由于未处理鼻中隔偏曲,出现了鼻小柱偏斜,鼻孔左右不对称。平均随访11.7个月,116例患者手术后鼻腔内无占位、无移植物凸出、患者自查外鼻阀无明显异物感觉、鼻尖可左右摆动,同时鼻尖表现点明显,下小叶饱满,无软骨显形、外露、感染等并发症。结论自体肋软骨皮质作为鼻尖支撑及修饰移植物塑造出的鼻尖柔软可活动,不影响气道,是鼻尖整形术中效果较可靠的技术,值得临床应用。

Objective To investigate the effect of autologous costal cartilage cortex as nasal tip support and modified graft for nasal tip contour improvement.Methods From June 2020 to June 2021,116 patients(male 26,female 90,aged 20-45 years)who received rhinoplasty in the cosmetic surgery department of Myoung Beaucare Clinic of Beijing,were examined the costal cartilage by CT,and the costal cartilage was cut.The costal cartilage cortex was made into"strip"and"cap"grafts to shape the nasal tip,and the nasal dorsum was raised by polytetrafluoroethylene or silicone prosthesis for comprehensive rhinoplasty.Results A total of 116 patients were followed up for an average of 11.7 months.After the operation,there was no space occupying in the nasal cavity,no graft protrusion,no obvious foreign body feeling in the nasal valve,and the nasal tip could swing left and right.At the same time,the nasal tip showed obvious signs,the lower lobule was full,and there were no complications such as cartilage appearance,exposure,infection,etc.Due to the untreated deviation of nasal septum,3 cases had deviation of nasal columella and asymmetric nostrils.The shape of nasal tip was stable in the remaining 113 cases,and satisfactory results were obtained.Conclusions By using autologous costal cartilage cortex as nasal tip support and modification graft for nasal tip contour improvement,the shaped nasal tip is soft and movable,and does not affect the airway.It is a good surgical technique in nasal tip plastic surgery,which is worthy of clinical application.