Hoshal Steven G, Solis Roberto N, Tollefson Travis T
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology -Head and Neck Surgery, University of California Davis, Sacramento, California.
Facial Plast Surg. 2020 Feb;36(1):102-111. doi: 10.1055/s-0040-1701477. Epub 2020 Mar 19.
Rhinoplasty for cleft lip nasal deformities challenges all cleft surgeons. There is great variability of phenotypical anatomy, but iatrogenic changes and scarring from the previous surgeries add another layer of complexity. Rhinoplasties on a patient with cleft lip-palate are technically and intellectually challenging to master requiring a patient-tailored approach. The shape and structure of the nose are changed to improve both function and aesthetic appearance. In the primary setting, nasoalveolar molding is a form of presurgical infant orthopaedics used for preparation before the cleft lip and nose repair. Intermediate stages should be conservative to minimize scarring, while the definitive cleft rhinoplasty utilizes cartilage grafts from septum, ear, or rib to sculpt the nose. Hereinto, we will outline the controversies, the evidence supporting certain techniques, and our preferences.
唇裂鼻畸形的鼻整形术对所有唇裂外科医生来说都是一项挑战。表型解剖结构存在很大差异，但既往手术造成的医源性改变和瘢痕又增加了一层复杂性。对唇腭裂患者进行鼻整形术，在技术和思维上都具有挑战性，需要采用针对患者的个体化方法。改变鼻子的形状和结构以改善功能和美观。在初次治疗时，鼻牙槽塑形是一种术前婴儿矫形方法，用于唇裂和鼻修复术前的准备。中间阶段应保守治疗以尽量减少瘢痕形成，而确定性唇裂鼻整形术则利用鼻中隔、耳或肋软骨移植来塑造鼻子。在此，我们将概述相关争议、支持某些技术的证据以及我们的偏好。
