经双鼻翼内侧缘闭合切口行鼻综合整形术.docVIP

经双鼻翼内侧缘闭合切口行鼻综合整形术 　　[摘要]目的：??用双鼻翼内侧缘闭合切口行鼻综合整形术，观察术后外鼻形态，尤其是鼻尖成形效果、瘢痕情况与传统切口的同类术进行比较。方法：应用双鼻翼内侧缘闭合切口，充分剥离、显露双侧鼻翼软骨内侧脚转折部（穹窿部），褥式缝合拉拢，以缩小鼻头，抬高鼻尖，同时置入假体-软骨/自体真皮复合体隆鼻，缝合切口。术后以热塑夹板固定塑形10d，8～10d拆线。结果：2014年4月-2016年3月，应用上述方法完成鼻综合整形-鼻尖成形手术56例，术后随访3个月～2年，术前低鼻尖、钝平鼻尖、肥厚鼻尖等缺陷术后均有明显改善，鼻形自然逼真，鼻尖成形效果好，鼻小柱无切口瘢痕，患者满意。 结论：应用双鼻翼内侧缘闭合切口的鼻综合整形术避免了传统切口的弊端，手术效果良好，患者满意度高。 　　[关键词]鼻综合整形；鼻尖；鼻翼软骨内侧脚；闭合入路；鼻翼内侧缘切口 　　[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2017）10-0006-04 　　Abstract： Objective To observe the shape of external nose after double nasal alar incision， especially the effect of nasal tip formation and scar， and compare with the traditional incision. Methods Two alar medial incision closure， full stripping， revealed bilateral alar cartilage medial foot turning part （fornix）， mattress suture rope， to narrow the nose， raise the tip of the nose， and implant - cartilage / autologous dermal complex rhinoplasty， incision suture. After operation， 10 days were fixed by thermoplastic splint and take out stitches 8-10 days after operation. Results From April 2014 to March 2016， using the above method to complete the comprehensive rhinoplasty and nasal tip rhinoplasty surgery in 56 cases， the patients were followed up for 3 months to 2 years， preoperative low nasal tip， blunt flat nose， hypertrophic nasal tip and other defects have improved significantly， the nose is natural and verisimilitude， the nose shape effect is good， no nasal columella incision scar， patient satisfaction is high. Conclusion The nasal rhinoplasty combined with rhinoplasty with double alar internal margin incision avoids the disadvantages of the traditional incision， and the operation effect is satisfactory and the patient satisfaction is high. 　　Key words： combined rhinoplasty； nasal alar cartilage； medial foot； closed approach； medial alar incision 　　鼻部的整形不仅仅是把鼻梁隆高，鼻部的各亚单位，特别是鼻尖和鼻翼的形态也是鼻整形手术中必须考虑的问题，鼻尖整形成功与否是决定整个鼻整形手术是否成功的重要标准[1]。一个漂亮的鼻尖，能让整个鼻子增色70%。在传统的鼻综合整形手术中，为了充分暴露鼻部解剖结构，方便操作，多数术者往往采用双鼻翼缘经鼻小柱开放切口，其优点毋庸置疑，但其缺点也是显而易