Department of Plastic, Aesthetic and Maxillofacial Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
Department of Plastic Surgery, East West Medical College and Hospital, Turag, Dhaka, Bangladesh.
J Plast Reconstr Aesthet Surg. 2024 Dec;99:238-246. doi: 10.1016/j.bjps.2024.09.075. Epub 2024 Sep 30.
Secondary unilateral cleft lip nasal deformity is a prevalent condition in the world, and surgical repair remains a formidable challenge. The objective of the study is to investigate functionally and aesthetically outcomes of a new technique using a complex of autologous costal cartilage and fascia grafts to repair the secondary unilateral cleft lip nasal deformity.
First, the autologous costal cartilage and fascia were harvested from a total of 34 patients with secondary unilateral cleft lip nasal deformity, who were undergoing treatments at the First Affiliated Hospital of Xi'an Jiaotong University from April 2020 to June 2023. Then, the cartilage was sub-divided into 6 pieces and placed on the depressed alar base, nasal columella, lower lateral cartilage, and nasal tip. At the same time, the fascia was trimmed to cover the nasal tip cap graft and augment the dorsum of the nose. Patient outcomes were assessed through subjective evaluation and objective anthropometric measurements. In addition, associated complications were also examined.
All were primary healing incisions, and no patients were encountered with any clinical complications. We found that the overall mean score of the Independent Rhinoplasty Outcome Score (IROS) was very good during the subjective assessment. Also, the objective measurements indicated an excellent nasal symmetry. Furthermore, both functionally and aesthetically satisfactory outcomes were obtained in all the patients during long-time follow-up.
Secondary rhinoplasty using the complex of autologous costal cartilage and fascia grafts is a safe and effective approach for unilateral cleft lip nasal deformity repair.
继发单侧唇裂鼻畸形在世界范围内较为常见，手术修复仍然是一个巨大的挑战。本研究旨在探讨使用自体肋软骨和筋膜复合体修复继发单侧唇裂鼻畸形的新方法的功能和美学效果。
首先，从 2020 年 4 月至 2023 年 6 月在西安交通大学第一附属医院接受治疗的 34 例继发单侧唇裂鼻畸形患者中采集自体肋软骨和筋膜。然后，将软骨分成 6 块，放置在鼻翼基底、鼻中隔、下外侧软骨和鼻尖凹陷处。同时，修剪筋膜覆盖鼻尖帽状移植物并增加鼻背。通过主观评估和客观人体测量评估患者的结果。此外，还检查了相关并发症。
所有切口均为一期愈合，无患者出现任何临床并发症。我们发现，在主观评估中，独立鼻整形术结果评分（IROS）的总体平均得分为非常好。此外，客观测量显示出极好的鼻对称性。此外，所有患者在长时间随访中均获得了功能和美学上满意的结果。
使用自体肋软骨和筋膜复合体进行继发鼻整形术是修复单侧唇裂鼻畸形的一种安全有效的方法。
