自体肋软骨联合硅胶假体修复注射式鼻整形的效果

Efficacy of autologous costal cartilage combined with silicone prosthesis for repair of injection rhinoplasty

目的:探讨用自体肋软骨联合硅胶假体对注射式鼻整形的修复效果。方法:2016年7月至2019年7月,绍兴市妇幼保健院医疗美容科收治因不满意注射式鼻整形外观而要求手术修复患者28例,男2例、女26例;年龄19~34岁,平均26.3岁。其中注射透明质酸填充26例,未知填充物2例。用自体肋软骨联合硅胶假体的方法,术后观察并发症,并用鼻整形(ROE)问卷评估每例患者术前和术后6个月的情况。结果:术后患者均未见皮肤感染坏死、假体变形移位和气胸等并发症,切口愈合顺利。患者均随访6~18个月,术前术后ROE问卷6个问题中,除问题2外,两者比较差异均有统计学意义(t=7.58,P<0.05)。结论:自体肋软骨结合硅胶假体能有效修复注射式鼻整形,既能达到满意的术后效果,又能减少手术并发症,且操作简便,值得临床应用。

Objective To investigate the repair effect of autologous costal cartilage combined with silicone prosthesis on injection rhinoplasty.Methods From July 2016 to July 2019,28 patients who were dissatisfied with the appearance of injectable rhinoplasty and required surgical repair were treated in our hospital.Among them,26 patients were injected with hyaluronic acid as filler,and 2 patients were unknown filler.On the basis of thoroughly cleaning the filler and releasing the adhesive tissue,the method of autogenous costal cartilage combined with silicone prosthesis was adopted:the costal cartilage was taken to support the nasal tip,and the silicone prosthesis was used to fill the nasal dorsum.The incidence of complications was observed postoperatively,and the score of each patient before and 6 months after operation was evaluated by ROE questionnaire.Results No postoperative complications such as skin infection and necrosis,prosthesis deformation and displacement,and pneumothorax were observed in all the patients,and the incision healing was smooth.All patients were followed up for 6-18 months.Among the 6 questions on the preoperative and postoperative ROE questionnaire,except for question 2,the difference between the the two was statistically significant(t=7.58,P<0.05).Conclusions The use of autologous costal cartilage combined with silicone prosthesis can effectively repair injection-type rhinoplasty,which can not only achieve satisfactory postoperative results,but also reduce surgical complications.It is easy to operate and worthy of choice in clinical practice.