Murakami C S, Cook T A, Guida R A
Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle.
Arch Otolaryngol Head Neck Surg. 1991 Mar;117(3):327-30; discussion 331. doi: 10.1001/archotol.1991.01870150095013.
Nasal structural reconstruction is a formidable task in cases where there is loss of support to both the nasal dorsum and tip. A multitude of surgical approaches and materials have been used for the correction of the saddle-nose deformity with varying degrees of success. Articulated irradiated rib cartilage inserted through an external rhinoplasty approach was used to reconstruct nasal deformities in 18 patients over a 6-year period. Simultaneous use of a midline forehead flap to reconstruct the overlying soft tissue was required in four cases. Follow-up ranged from 1 to 6 years (mean, 2.8 years). Results were rewarding in most cases with marked improvement in nasal support and airway. Revision and/or replacement secondary to trauma or warping of the graft was required in four cases. None of the patients exhibited infection, extrusion, or noticeable resorption. A description of the surgical technique, review of all the cases, and recommendation for continued use of this graft material are discussed.
在鼻背和鼻尖均失去支撑的情况下，鼻结构重建是一项艰巨的任务。众多手术方法和材料已被用于矫正鞍鼻畸形，取得了不同程度的成功。在6年期间，采用经鼻外整形手术方法植入的关节化辐照肋软骨对18例患者进行鼻畸形重建。4例患者同时需要使用中线额部皮瓣重建覆盖的软组织。随访时间为1至6年（平均2.8年）。大多数病例效果良好，鼻支撑和气道有明显改善。4例患者因移植片受创伤或弯曲需要进行修复和/或更换。所有患者均未出现感染、排斥或明显吸收。本文讨论了手术技术描述、所有病例回顾以及对继续使用这种移植材料的建议。
