Jiang Zhiyuan, You Xiaobo, Cai Zhen, Liu Quan, Du Liping, Cui Wei, Chen Zaihong, Sheng Yang
Department of Plastic Surgery, Sichuan Provincial People's Hospital & Sichuan Academy of Medical Sciences, Chengdu Sichuan, 610072, P.R.China.
Department of Plastic Surgery, Sichuan Provincial People's Hospital & Sichuan Academy of Medical Sciences, Chengdu Sichuan, 610072,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Aug 15;32(8):1056-1060. doi: 10.7507/1002-1892.201802064.
To investigate the technical points and effectiveness of autogenous costal cartilage transplantation in repair of Binder's syndrome.
Between June 2012 and June 2017, 8 cases of Binder's syndrome were admitted. There were 3 males and 5 females, aged 16-31 years (mean, 22 years). All patients were conformed to the typical manifestations of Binder's syndrome. The autogenous costal cartilage was harvested and carved into the nasal dorsum graft, nasal column graft, and nasal basement graft. Before and after operation, standard pictures of the anterior view, lateral view, and base view were taken to measure facial related parameters of nasal dorsum length, nasal columella-lobule ratio, nasofrontal angle, nasal columella-upper lip angle, nasal tip projection rate, and nasion projection. Then the effectiveness of this surgical procedure for Binder's syndrome was evaluated.
All incisions healed by first intention without acute infections. All patients were followed up 6-36 months, with an average of 18 months. The foreign body sensation in upper lip and scar hyperplasia in thoracic incision occurred in 1 case, respectively. The nasal morphology improved significantly and the coordinated relationships of the nose with the upper lip and face were restored postoperatively. Postoperative parameter measurements were taken in 6 cases. The nasal dorsum length, nasal columella-lobule ratio, nasofrontal angle, nasal columella-upper lip angle, nasal tip projection rate, and nasion projection at preoperation were significantly improved when compared with the values at 6 months after operation ( <0.05). The difference in nasal dorsum length, nasal tip projection rate, and nasion projection between actual values at 6 months after operation and normal values was no significant ( <0.05). There was significant difference in nasal columella-lobule ratio between actual value at 6 months after operation and normal value ( >0.05).
Autogenous costal cartilage transplantation in repair of Binder's syndrome can obviously improve patients' appearance of the external nose and middle face, and obtain the persistent effectiveness.
探讨自体肋软骨移植修复Binder综合征的技术要点及疗效。
2012年6月至2017年6月，收治8例Binder综合征患者。其中男性3例，女性5例，年龄16 - 31岁（平均22岁）。所有患者均符合Binder综合征的典型表现。取自体肋软骨并雕刻成鼻背移植物、鼻小柱移植物和鼻基底移植物。手术前后拍摄正面、侧面和底面标准照片，测量鼻背长度、鼻小柱 - 鼻尖比例、鼻额角、鼻小柱 - 上唇角、鼻尖突出率及鼻根突出度等面部相关参数，然后评估该手术治疗Binder综合征的疗效。
所有切口均一期愈合，无急性感染发生。所有患者随访6 - 36个月，平均18个月。分别有1例出现上唇异物感和胸部切口瘢痕增生。术后鼻外形明显改善，鼻与上唇及面部的协调关系得以恢复。对6例患者进行术后参数测量。术前鼻背长度、鼻小柱 - 鼻尖比例、鼻额角、鼻小柱 - 上唇角、鼻尖突出率及鼻根突出度与术后6个月时相比差异有统计学意义（<0.05）。术后6个月实际值与正常值在鼻背长度、鼻尖突出率及鼻根突出度方面差异无统计学意义（<0.05）。术后6个月实际值与正常值在鼻小柱 - 鼻尖比例方面差异有统计学意义（>0.05）。
自体肋软骨移植修复Binder综合征可明显改善患者外鼻及中面部外观，并获得持久疗效。
