自体耳软骨联合硅胶假体在唇裂Ⅱ期鼻畸形整复中应用.docVIP

自体耳软骨联合硅胶假体在唇裂Ⅱ期鼻畸形整复中应用[摘要]目的：探索应用自体耳软骨联合硅胶假体整复唇裂Ⅱ期鼻畸形的方法。方法：针对成年唇裂Ⅱ期鼻畸形患者鼻小柱短小，鼻尖低平，鼻翼塌陷等畸形。取适量自体耳甲腔软骨塑形，附于硅胶假体鼻尖部，分离、复位并固定患侧鼻翼软骨，通过隆鼻来延长鼻小柱，抬高鼻尖，矫正鼻翼塌陷，重塑外鼻自然形态。结果：对本组32例患者随访3个月～18个月，外鼻形态、色泽、手感均满意，无假体排异现象。供区耳郭外形正常。结论：自体耳软骨联合硅胶假体能有效重建鼻部正常生理性支架结构，整复唇裂Ⅱ期鼻畸形效果明显。 [关键词]鼻畸形；自体耳软骨；硅胶假体 [中图分类号]R622 [文献标识码]A [文章编号]1008-6455（2008）03-03 Nasal deformity corrected by auricular cartilage in conjuction with silicone prosthesis XIN Hai-long1,XIE Ai-guo2,TAN Qian2 (1.Department of Burns and Plastic Surgery, Nangang Hospital, Nanjing 210035, Jiangsu, China; 2. Department of Burn and Plastic Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China) Abstract:ObjectiveTo explorethe application of auricularcartilage in conjuction with silicone prosthesis to correctthe nasal deformity. MethedsAugmentation rhinoplasltywas perfommndonpatientswith a short nose with a low flat, blunt break point; at the same time the upper lateral part of the nasal ala cartilage was cut to reduce the width and uhgthen the nasal columella ,and the auricular cantilage in cinjuction with silicone prosthesis was used to raise and extend the break point.Results32 cases were involved, the effects were satisfactory and there is no complication by follow-up from 3 to 18 months. In addition, the appearance of the pinna in the donor site had no change. ConclusionAuricular cartilage in conjuction with silicone prosthesis can accomplish the supportine function of nasal cartilage struction and a simple augmentation rhinoplasly with this methed is effective to correce the nasal deformity cause by cleft lip. Key words: nasal deformity; auricular cartilage; silicone prosthesis 唇裂是发病率较高的一种先天性畸形，外科手术整复是治疗的唯一方法。先天性唇裂Ⅰ期整复术后，往往继发不同程度的鼻畸形，表现为鼻小柱短小，鼻尖低平，鼻翼塌陷等，需行Ⅱ期整复术，针对唇裂Ⅱ期鼻畸形的成年患者，单纯作患侧鼻翼软骨分离、悬吊，由于缺少生理性支架结构支撑，效果不甚理想[1]。我们于2004年9月～2007年9月，应用自体耳软骨联合硅胶假体，重建鼻部正常生理性支架结构[2]，整复唇裂Ⅱ期鼻畸形32例，取得良好效果。 1临床资料 本组共32例患者，男性20例，女性12例；年龄16～25岁，平均20岁。左侧唇裂Ⅱ期鼻畸形12例，右侧唇裂