鼻中隔软骨及肋软骨在唇裂鼻畸形修复中比较探究.docVIP

鼻中隔软骨及肋软骨在唇裂鼻畸形修复中比较探究[摘要]目的:通过自体鼻中隔软骨和肋软骨在唇裂鼻畸形修复中的比较研究,为进一步完善唇裂鼻畸形的手术方法提供依据。方法:切取自体的鼻中隔软骨或肋软骨,制成鼻支架;植入鼻支架并进行解剖复位。采用定性的方法观察二组患者术后鼻底宽度对称性、鼻尖、鼻孔形态、鼻小柱高度、鼻背形态和鼻翼对称性,然后进行比较分析。结果:自体鼻中隔软骨与自体肋软骨植入矫正唇裂鼻畸形患者,在鼻底宽度和对称性、鼻孔形态、鼻翼对称性的改善中二组间无明显统计学意义;而鼻小柱高度、鼻背形态和鼻尖形态的改善二组间有统计学意义。结论:自体肋软骨组较自体鼻中隔软骨组对鼻部形态的改善更明显;但自体肋软骨组有创伤大、患者难于接受等缺点;自体鼻中隔软骨组创伤小、无第二手术野,可利用的组织量过少。因此,本研究认为:利用鼻中隔软骨或肋软骨矫正唇裂鼻畸形各有优缺点,需谨慎选择、因人而异。 [关键词]唇裂;鼻畸形;肋软骨;鼻中隔软骨 [中图分类号]R622 [文献标识码]A [文章编号]1008-6455(2010)10-1449-07 Comparison with nasal septal cartilage and costal cartilage in the cleft lip nasal deformity SONG Zhi-yong1,LI Xiao-lin2,WU Guo-hui2,WANG Wen-ying2 (1.Department of Burn and Plastic Surgery,Liuyang Traditional Chinese Medical Hospital, Liuyang 410300,Hunan,China;2. Department of Plastic and Maxillofacial Surgery, Jiangxi Provincial People’s Hospital,Nanchang 330006,Jiangxi,China) Abstract: ObjectiveThe purpose of this study is to research an effective method to deal with the cleft lip nasal deformity in the comparison of the reconstruction of nasal deformitieswith application of nasal septal cartilage and costal cartilage.MethodsWe make a nasal stent with the septal cartilage or costal cartilage which is taken from their body. The nosal formation was reconstructed when the nasal stent is implanted. Using the method of qualitative analysis,we observed two groups of the patients in nasal base width symmetry,nose tip,nostril shape,nasal columella height,nasal dorsum shape and alar symmetry.ResultsThere has no statistical significance in the width of the nasal base,nostril shape,the improvement in alar symmetry between the two groups. There has statistical significance in the nasal columella height,nasal dorsum shape,nasal tip between the two groups.ConclusionThe group autogenous costal cartilage was grafted has better results than the group autogenous septal cartilage was simply implanted. To get autogenous septal cartilage does not require a second surgical field,but the septal cartilage is to