Suh Joong Min, Uhm Ki Il
Department of Plastic and Reconstructive Surgery, Kangdong Sacred Heart Hospital, Seoul, Korea.
Arch Craniofac Surg. 2021 Apr;22(2):85-92. doi: 10.7181/acfs.2021.00010. Epub 2021 Apr 20.
Patients with secondary deformities associated with unilateral cleft lip and nose might also suffer from nostril stenosis due to a lack of tissue volume in the nostril on the cleft side. Here, we used full-thickness skin grafts (FTSGs) to reduce nostril stenosis and various methods for skin volume augmentation. We compared the changes in the symmetry of both nostrils before and after surgery.
From February 2016 to January 2020, 34 patients underwent secondary cheiloplasty and open rhinoplasty for secondary deformities of the unilateral cleft lip and nose with nostril stenosis. FTSG was used on the nostril floor, nasal columella, and alar inner lining. The measured nasal profile included the nostril surface, nostril circumference, width of the nostril floor, and distance from the alar-facial groove to the nasal tip. The "overlap area," which was defined as the largest overlapping area when the image of the cleft nostril was flipped to the left and right and overlaid on the image of the normal side nostril, was also calculated. The degree of symmetry was evaluated by dividing the value of the cleft side by that of the normal side of each measured profile and expressed as "ratios."
The results of all profile ratios, except for the nostril floor width, became significantly close to 1, which represents full symmetry. The overlap area ratio improved from 62.7% to 77.3%, meaning that the length and width of the nostril as well as the overall shape became similar (p< 0.05).
When performing cleft rhinoplasty with nostril stenosis, FTSG is useful to achieve symmetry in the nostril size and shape. Skin grafting is simpler to perform than the other types of local flap, and the results are generally satisfactory.
单侧唇裂鼻继发畸形患者可能因患侧鼻孔组织量不足而出现鼻孔狭窄。在此，我们使用全厚皮片（FTSG）来减轻鼻孔狭窄并采用多种增加皮肤量的方法。我们比较了手术前后双侧鼻孔对称性的变化。
2016年2月至2020年1月，34例患者因单侧唇裂鼻继发畸形伴鼻孔狭窄接受二期唇成形术和开放式鼻成形术。在鼻孔底部、鼻小柱和鼻翼内衬使用全厚皮片。测量的鼻部轮廓包括鼻孔表面、鼻孔周长、鼻孔底部宽度以及从鼻翼面部沟到鼻尖的距离。还计算了“重叠面积”，其定义为将患侧鼻孔图像左右翻转并叠加在正常侧鼻孔图像上时的最大重叠面积。通过将每个测量轮廓的患侧值除以正常侧值来评估对称程度，并表示为“比率”。
除鼻孔底部宽度外，所有轮廓比率的结果均显著接近1，这代表完全对称。重叠面积比率从62.7%提高到77.3%，这意味着鼻孔的长度、宽度以及整体形状变得相似（p<0.05）。
在进行伴有鼻孔狭窄的唇裂鼻成形术时，全厚皮片有助于实现鼻孔大小和形状的对称。植皮比其他类型的局部皮瓣操作更简单，且结果通常令人满意。
