Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawaharacho, Sakyou-ku, Kyoto, 606-8507, Japan.
J Plast Reconstr Aesthet Surg. 2012 Jul;65(7):857-63. doi: 10.1016/j.bjps.2012.01.002. Epub 2012 Jan 25.
Although many articles have investigated the optimal method for the primary correction of nasal deformities during unilateral cleft lip repair, residual nasal deformities often remain. Such residual deformities are commonly corrected around the age of 5. We have started performing two-stage nasal repair operations for unilateral cleft lip patients. During the first stage, the nasal floor is elevated, and the alar base is brought into the correct position by muscle reconstruction during primary lip repair. During the second stage, the slanting nasal apex and drooping alar rim are corrected at pre-school age. This article describes the methods and results of second-stage open rhinoplasty.
Open rhinoplasty is performed. The conchal cartilage is harvested and used as a strut to strengthen and extend the septum. The lower lateral cartilages are sutured to the grafted cartilage and fixed in the correct position. The operative results of 38 patients were evaluated photogrammetrically. The nasal height, nostril height and the columella angle on a basilar view of the nose were measured.
In most patients, the nose was refined and became less distorted. Poorly projecting nasal tips and drooping alar rims were corrected. The reformed configuration was relatively well maintained for many years. Photogrammetric analysis demonstrated increases in both the nasal height to nasal width ratio and the nostril height to nostril width ratio, and improvement of the columella angle.
Performing open rhinoplasty using conchal cartilage during childhood effectively improves unilateral cleft-lip nasal deformities.
尽管许多文章已经探讨了在单侧唇裂修复中初次矫正鼻畸形的最佳方法，但仍会遗留一些鼻部畸形。这些残余畸形通常在 5 岁左右进行矫正。我们开始对单侧唇裂患者进行两阶段的鼻部修复手术。在第一阶段，通过初次唇修复时的肌肉重建来抬高鼻底，并将鼻翼基底带入正确位置。在第二阶段，在学龄前矫正斜鼻尖和下垂的鼻翼缘。本文描述了两阶段开放式鼻整形术的方法和结果。
进行开放式鼻整形术。采集耳软骨作为支撑物，以加强和延长鼻中隔。将下外侧软骨缝合到移植的软骨上，并固定在正确的位置。通过摄影测量法评估了 38 例患者的手术结果。测量鼻底视图上的鼻高度、鼻孔高度和鼻中隔角。
在大多数患者中，鼻子变得更加精致，畸形程度减轻。改善了鼻尖突出度不足和鼻翼下垂的问题。重建的形态多年来保持相对良好。摄影测量分析显示，鼻高度与鼻宽比以及鼻孔高度与鼻孔宽度比增加，鼻中隔角得到改善。
在儿童期使用耳软骨进行开放式鼻整形术可有效改善单侧唇裂鼻畸形。
