Y形耳甲软骨移植对唇裂继发鼻畸形矫正的效果及其对心理健康的影响。

The effects of Y-shaped conchal cartilage transplantation on the correction of nasal deformity secondary to cleft lip and its influence on mental health.

作者信息

Liu Ling, Wang Wei, Yang Lin, Zhang Hongchuang

机构信息

Department of Cosmetology, The First People's Hospital of Xuzhou, Xuzhou, Jiangsu 221002, P.R. China.

Department of Plastic Surgery, The First People's Hospital of Xuzhou, Xuzhou, Jiangsu 221002, P.R. China.

出版信息

Exp Ther Med. 2017 Oct;14(4):3549-3554. doi: 10.3892/etm.2017.4994. Epub 2017 Aug 22.

Abstract

Patients who undergo corrective surgery for cleft lip are known to be at risk for subsequently developing secondary nasal deformity. The aim of this study was to investigate the effects of Y-shaped conchal cartilage transplantation on the correction of nasal deformity secondary to cleft lip and its influence on mental health. Sixteen patients with nasal deformity secondary to cleft lip admitted to The First People's Hospital Xuzhou (Xuzhou, China) from February 2014 to February 2015 were selected for the study. Conchal cartilage was taken from the patients and made into a Y-shaped stent, which was then transplanted into the nasal columella. The surgical outcomes and patient satisfaction were evaluated and HADS was used to compare the preoperative and postoperative mental health. After the affected side of the nose was corrected, the nasal profiles of 12 patients were significantly improved, the height of nasal columella and nostril was significantly increased, the nasal base and breadth were significantly shorter than those before operation and the nose wing-nasal breadth index on the affected side was significantly increased compared to that before operation and the differences were statistically significant (P<0.05). The satisfaction of each index after the operation was more than 90%. The mental health of patients after operation was notably improved compared to before operation and the difference was statistically significant (P<0.05). After the correction of secondary nasal deformity to cleft lip through Y-shaped conchal cartilage transplantation, the shape of the nasal tip was stable without the recurrence of deformities or distortion on the donor site of the auricle. Y-shaped conchal cartilage transplantation is an ideal treatment method for the moderate and severe secondary nasal deformity to cleft lip and effective perioperative mental intervention can improve the patient's mental health status, an outcome that is worth popularizing in clinical applications.

摘要

接受唇裂矫正手术的患者已知有随后发生继发性鼻畸形的风险。本研究的目的是探讨Y形耳甲软骨移植对唇裂继发鼻畸形矫正的效果及其对心理健康的影响。选取2014年2月至2015年2月在徐州市第一人民医院(中国徐州)收治的16例唇裂继发鼻畸形患者进行研究。从患者身上获取耳甲软骨并制成Y形支架,然后将其移植到鼻小柱。评估手术效果和患者满意度,并使用医院焦虑抑郁量表(HADS)比较术前和术后的心理健康状况。患侧鼻矫正后,12例患者的鼻外形明显改善,鼻小柱和鼻孔高度明显增加,鼻底和宽度明显短于术前,患侧鼻翼-鼻宽度指数较术前明显增加,差异有统计学意义(P<0.05)。术后各指标满意度均超过90%。患者术后心理健康状况较术前明显改善,差异有统计学意义(P<0.05)。通过Y形耳甲软骨移植矫正唇裂继发鼻畸形后,鼻尖形状稳定,耳廓供区无畸形复发或变形。Y形耳甲软骨移植是治疗唇裂中重度继发鼻畸形的理想方法,有效的围手术期心理干预可改善患者的心理健康状况,这一结果值得在临床应用中推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d2e/5639310/f159e00de308/etm-14-04-3549-g00.jpg

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