Ma Zhibing, Wang Yawen, Chen Gang, Wang Jinming, Zhang Jun, Huang Jinlong
From the Department of Plastic Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing.
Ann Plast Surg. 2021 Mar 1;86(3S Suppl 2):S287-S292. doi: 10.1097/SAP.0000000000002636.
Nasal soft triangle is one of the areas usually left unattended in most rhinoplasties, whereas its unique anatomy puts it at great risk of deformities. Its appearance is critical to the natural contour of the nasal tip lobule. The purpose of this study was to evaluate the outcome of autologous cartilage transplantation in treating congenital nasal soft triangle deformities in Asians.
From January 2016 to January 2018, 32 patients underwent the procedure, in which costal cartilage, septal cartilage, or conchal cartilage was taken. All cases were operated upon using the external rhinoplasty approach. The cartilage was carved into battens as the lateral and intermediate crura grafts to reconstruct the dome of alar cartilage and treat the soft triangle deformities. The costal cartilage or septal cartilage was used as a columella strut. At the same time, a prosthesis or costal cartilage scaffold was placed onto the nasal dorsum, and finally the fascia was placed on the tip of the nose to relieve tension. The changes of the angle between the intermediate and lateral crura of the alar cartilage before and after cartilage graft and the difference between the greatest distance from the long axis of the nostrils to the alar rim before and after surgery were statistically analyzed. In addition, we compared the preoperative and postoperative nasal contour and evaluated the outcome of soft tissue triangle deformities and asymmetry correction and the whole procedure.
The angle between the lateral and medial crura of the 32 patients decreased from 51.5 ± 10.9 degrees preoperatively to 37.2 ± 5.9 degrees at completion of the nasal dome reconstruction (P < 0.05). The maximum distance from the long axis of the nostrils to the alar rim was 3.3 ± 0.6 mm preoperatively and 1.9 ± 0.7 mm postoperatively (P < 0.05). The patients were followed up for 6 to 18 months, and the noses were with natural contour and tactile impression and without any serious complications. The degree of satisfaction was 87.5%.
The application of autologous cartilage is an ideal choice to treat soft triangle deformities, which can result in significant improvement of the nasal contour and high degree of satisfaction postoperatively.
鼻软三角是大多数鼻整形术中通常被忽视的区域之一，但其独特的解剖结构使其极易出现畸形。其外观对鼻尖小叶的自然轮廓至关重要。本研究的目的是评估自体软骨移植治疗亚洲人先天性鼻软三角畸形的效果。
2016年1月至2018年1月，32例患者接受了该手术，术中取肋软骨、鼻中隔软骨或耳甲软骨。所有病例均采用鼻外入路手术。将软骨雕刻成板条作为外侧和中间脚移植片，以重建鼻翼软骨穹顶并治疗软三角畸形。肋软骨或鼻中隔软骨用作鼻小柱支撑。同时，在鼻背放置假体或肋软骨支架，最后在鼻尖放置筋膜以减轻张力。对软骨移植前后鼻翼软骨中间脚与外侧脚之间的角度变化以及手术前后鼻孔长轴至鼻翼缘最大距离的差异进行统计学分析。此外，我们比较了术前和术后的鼻轮廓，评估了软组织三角畸形和不对称矫正的效果以及整个手术过程。
32例患者鼻翼软骨外侧脚与内侧脚之间的角度从术前的51.5±10.9度降至鼻穹顶重建完成时的37.2±5.9度（P<0.05）。术前鼻孔长轴至鼻翼缘的最大距离为3.3±0.6mm，术后为1.9±0.7mm（P<0.05）。患者随访6至18个月，鼻部轮廓自然，触感良好，无任何严重并发症。满意度为87.5%。
自体软骨的应用是治疗软三角畸形的理想选择，可显著改善鼻轮廓，术后满意度高。
