耳后筋膜组织在修复鼻背假体显形中的应用

Application of Retroauricular Fascia Tissue in Repairing the Appearance of Nasal Dorsal Prosthesis

目的:探讨自体耳后筋膜组织修复鼻背假体显形的效果。方法:选取2020年10月-2022年8月收治的100例隆鼻就医者,所有就医者均采用自体软骨搭建鼻尖支架,取自体右侧耳后筋膜覆盖假体填充鼻背术式。术后随访并拍照,记录两组术后并发症发生情况,评估临床效果及满意度。结果:术后随访6~18个月,就医者术后恢复时间为(8.2±1.5)d,满意度评分为4.2分。术后3例(3%)出现耳后术区血肿,其中2例于术后4h返回手术室行清创术,1例加压包扎保守治疗。5例(5%)就医者在术后出现耳后皮肤触觉减退,其中2例早期有痛觉敏感,6例(6%)出现早期鼻背偏宽,于术后半年经组织消肿,筋膜吸收后改善。就医者总体对鼻背形态改善满意率高。结论:自体耳后筋膜组织覆盖假体可改善鼻背假体轮廓感且显形效果好,对于处理和预防鼻背假体显形的就医者是一种可行的手术方法。

Objective To explore the effect of autogenous retroauricular fascia in repairing the appearance of nasal dorsum prosthesis.Methods A total of 100 patients admitted from October 2020 to August 2022 were selected.All patients used autologous cartilage to build nasal tip scaffolds,and the right posterior ear fascia was taken to cover the prosthesis to camouflage the dorsum of the nose.Postoperative follow up and photos were taken,record the occurrence of postoperative complications and evaluate the clinical effect and satisfaction.Results The patients were followed up for 6 to 18 months.The postoperative recovery time was(8.2±1.5)d and the satisfaction score was 4.2.Postoperative hematoma occurred in 3 cases(3%),of which 2 cases returned to the operating room for debridement 4 hours after operation,and 1 case was treated conservatively with pressure bandage.5 patients(5%)had postauricular skin tactile decline and 2 of them have pain sensitivity in the early stage after surgery,and 6 patients(6%)had wide nasal dorsum,which improved after tissue detumescence and fascia absorption half one year after surgery.The overall satisfaction rate of patients with nasal dorsum morphology was high.Conclusion Autogenous retroauricular fascia was covered on prosthesis has a good effect in improving the contour and appearance of nasal dorsum prosthesis,which is a feasible surgical method for the treatment and prevention of the appearance of nasal dorsum prosthesis.