一体式膨体聚四氟乙烯假体在改善鼻基底凹陷中的临床效果分析

Clinical effectiveness analysis of integrated expanded polytetrafluoroethylene prosthesis in improving nasal base depression

目的 探讨一体式膨体聚四氟乙烯假体在改善鼻基底凹陷中的临床效果及优势。方法 回顾性分析自2019年12月至2021年6月,成都高新心悦容医疗美容门诊部收治的134例伴有鼻基底凹陷患者的临床资料。根据患者鼻基底凹陷形态采用膨体聚四氟乙烯雕刻个性化一体式假体,单纯行鼻基底填充者在双侧齿龈沟上1.0 cm处设计横向2.0 cm切口,剥离梨状孔旁区骨膜下腔隙并两侧贯通,从一侧向另一侧置入假体;同时行鼻整形术者从鼻部切口剥离腔隙并置入假体。对术后并发症、切口瘢痕、鼻基底改善情况、整体满意度进行评估,测量手术前后鼻翼基底凹陷度、鼻翼宽度、人中长度,并进行比较。结果 134例患者切口均一期愈合,所有患者获随访10~26个月,无明显瘢痕形成。8例出现术后异物感、表情不自然,3个月后逐渐恢复;1例出现单侧上唇黏膜顶出,经再次手术调整后好转。非常满意123例,满意8例,一般3例。手术前后鼻翼基底凹陷度、鼻翼宽度、人中长度比较,差异具有统计学意义(P<0.05)。结论 采用一体式膨体聚四氟乙烯假体填充鼻基底的手术方法安全、有效、操作简便,可明显改善鼻基底凹陷,减少不对称及假体移位风险,是改善鼻基底凹陷的理想方法之一。

Objective To investigate the clinical effectiveness and advantage of integrated expanded polytetrafluoroethylene(e-PTFE)prosthesis in improving nasal base depression.Methods From December 2019 to June 2021,the clinical data of 134 patients with nasal base depression admitted to Chengdu High-tech Zone Xinyuerong Medical Aesthetic Clinic were retrospectively analyzed.The expanded polytetrafluoroethylene was used to carve personalized integrated prosthesis according to the shape of the nasal base depression of the patient.A transverse incision of 2.0 cm was designed at 1.0 cm above the bilateral gingival furrows for patients who only underwent nasal base filling,and the subperiosteal space in the piriform aperture was dissected and connected on both sides,and the prosthesis was inserted from one side to the other.The cavity space was dissected from the nasal incision and the prosthesis was inserted in the patients who underwent nasal plastic surgery at the same time.Postoperative complications,incisional scars,improvement of nasal base,and overall satisfaction were evaluated.The nasal base depression,nasal alar width,and upper lip length were measured before and after surgery.Results The 134 patients in this group were followed up for 10 to 26 months,and all the incisions healed in one stage without obvious scar formation.Eight cases had postoperative foreign body sensation and unnatural expression,which gradually recovered after 3 months.One case of a unilateral lip mucosa ejection,was adjusted by reoperation.One hundred and twenty-three cases were very satisfied,8 cases were satisfied,and 3 cases were average.There were significant differences in nasal base depression,nasal alar width and upper lip length before and after operation(P<0.05).Conclusion The surgical method of filling the nasal base with an integrated e-PTFE prosthesis is safe,effective and easy to operate.It can obviously improve the nasal base depression and reduce the risk of asymmetry and displacement of the prosthesis.It is one of the ideal methods to improve the nasal base depression.