Li K Y, Li B H, Wang J, Chen L J, Zhou X
Head and Neck Cosmetic Surgery Center of Beijing Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100144, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Mar 7;56(3):242-248. doi: 10.3760/cma.j.cn115330-20200506-00376.
To explore the feasibility of reconstruction of nasal tip with septal cartilage and auricular cartilage. From September 2018 to October 2019, 17 patients (two males and fifteen females) with low noses underwent rhinoplasty under general anesthesia. The age of the patients ranged from 19 to 39, with an average of 27 years old. Among them, all the 17 cases were primary rhinoplasty. During the operation, autologous nasal septum cartilage was used as septal extension graft to extend the caudal septum, and the auricular cartilage was used to enhance the stability of the strut and to elevate the tip for adjusting the shape of nose by making into spreader graft, columellar strut graft, derotation graft and onlay graft. The nasal dorsum was filled with polytetrafluoroethylene. Digital scanning technology was used to evaluate the nasal structure before and after operation. SPSS 22 software was used to analyze the data with paired -test. The follow-up was from 6 to 12 months, with an avaerge of 7.6 months. Seventeen patients were satisfied with postoperative nasal morphology and height. There was no infection, prosthesis displacement, skin flap necrosis, no auricle deformation and other complications. Statistical software SPSS 22 performed paired test on the preoperative and postoperative data obtained by digital technology: postoperative nasal length and nasal tip protrusion increased compared with that before surgery, and it was statistically significant(length:(3.60±0.77)mm, tip protrusion:(3.61±0.64)mm, value was -19.203 and -23.132 respectively, both <0.001). The nasolabial Angle was smaller than that before surgery, and the data were statistically significant(3.40°±2.11°,=6.635, <0.001). The nasal tip and nasal septum extension complex constructed by autogenous nasal septal cartilage combined with auricular cartilage can increase the length of nasal tip, increase the height of nasal tip and reduce the angle of nasolabial angle.
探讨鼻中隔软骨和耳软骨重建鼻尖的可行性。2018年9月至2019年10月,17例低鼻患者(2例男性,15例女性)在全身麻醉下接受隆鼻手术。患者年龄19至39岁,平均27岁。其中,17例均为初次隆鼻手术。术中采用自体鼻中隔软骨作为鼻中隔延伸移植物延长鼻中隔尾端,采用耳软骨制作鼻小柱支撑移植物、鼻中隔支撑移植物、旋转矫正移植物和覆盖移植物等,增强支撑稳定性并抬高鼻尖以调整鼻形。鼻背填充聚四氟乙烯。采用数字扫描技术评估手术前后鼻结构。使用SPSS 22软件进行配对检验分析数据。随访6至12个月,平均7.6个月。17例患者对术后鼻形态和高度满意。未出现感染、假体移位、皮瓣坏死、耳廓变形等并发症。统计软件SPSS 22对数字技术获取的术前和术后数据进行配对检验:术后鼻长度和鼻尖突出度较术前增加,差异有统计学意义(鼻长度:(3.60±0.77)mm,鼻尖突出度:(3.61±0.64)mm,t值分别为-19.203和-23.132,均<0.001)。鼻唇角较术前变小,差异有统计学意义(3.40°±2.11°,t=6.635,<0.001)。自体鼻中隔软骨联合耳软骨构建的鼻尖和鼻中隔延伸复合体可增加鼻尖长度,提高鼻尖高度,减小鼻唇角。