25例鼻头肥大矫正的临床分析

Clinical experience in correction of bulbous nasal tip

目的 探讨不同类型鼻头肥大的治疗方法.方法 2013年8月至2016年3月,收治25例鼻头肥大患者,通过开放式的鼻整形方法,根据鼻翼软骨的形态和鼻头的软组织厚度情况,采用贯穿穹窿缝合和穹窿间的缝合方法,在此基础上5例行穹窿间脂肪切除,2例进行穹窿间脂肪填充鼻尖上转折区;17例同时伴有低鼻者,使用了鼻小柱肋软骨支撑移植物和鼻翼缘支撑移植物;1例进行了纤维脂肪瓣的拉拢缝合以及鼻翼软骨外侧脚跨越缝合.结果 本组25例患者,切口均一期愈合,术后随访3～20个月,平均(5±0.6)个月,无感染及复发,无通气功能障碍.结论 根据鼻头肥大的不同情况,确定解剖学基础,再采取相应的治疗方法,能够达到较好的临床效果.

Objective To discuss the efficacy and safety of various techniques in modification of bulbous nasal tip .Methods Transdomal suture and interdomal suture were performed in 25 patients using open rhinoplasty .Interdomal fat pads were resected in 5 patients and transferred to supratip regions in 2 patients due to the volume deficiency .The columellar strut and alar contour grafts were applied in 17 Patients with low nasal dorsum .The suture of soft tissue flaps and lateral crural spanning suture were used in one patient .Results All incisions healed primarily .No infections and aesthetic or functional complications were reported during the follow-up period between 3 to 20 months.Conclusions Bulbous nasal tips can be corrected with satisfactoryresult by applying different techniques according to their anatomic features .