Y形自体耳甲软骨移植整复双侧唇裂鼻畸形的临床评价

来源:用户上传      作者:韩志强　徐静　吴贝贝　孙晓涵　张硕　李光早

　　[摘要]目的：Y形自体耳甲软骨移植整复双侧唇裂鼻畸形的临床治疗效果进行评价。方法：以笔者医院收治的16例双侧唇裂鼻畸形患者为研究对象，保留耳轮脚等耳廓支撑结构，切取C形自体耳甲软骨制备成Y形软骨支架植入鼻小柱，重塑鼻翼软骨支撑结构和鼻尖外形，并利用三维激光扫描技术评价手术治疗效果。结果：术后对16例双侧唇裂鼻畸形患者进行1～2年随访，均获得满意效果。术后患者满意度均在90%以上。通过二维线性测量分析表明，术后鼻小柱、鼻孔高度较术前明显增加，差异有统计学意义（P<0.05）。鼻基底、鼻宽较术前显著缩短，差异有统计学意义（P<0.05）。通过三维空间差异对比表明，术后鼻部塌陷较术前得到极大改善。后期随访唇鼻外形良好，效果稳定，耳廓供区无继发畸形发生。结论：经该术式切取C形耳甲软骨，制备成Y形自体耳甲软骨移植整复双侧唇裂鼻畸形是一种理想手术方法，值得在临床推广应用。
　　[关键词]唇裂;鼻畸形;耳甲软骨;移植;鼻整形;三维激光扫描;继发畸形
　　[中图分类号]R782.2 [文献标志码]A [文章编号]1008-6455（2022）01-0037-04
　　Evaluation of Y-shaped Autologous Cartilage Transplantation on Correction of Bilateral Cleft Lip Nasal Deformity
　　HAN Zhiqiang，XU Jing，WU Beibei，SUN Xiaohan，ZHANG Shuo，LI Guangzao
　　（Department of Plastic Surgery，the First Affiliated Hospital of Bengbu Medical College， Bengbu 233000，Anhui，China）
　　Abstract： Objective To evaluate the clinical effect of Y-shaped autologous conchal cartilage transplantation in the repair of bilateral cleft lip nasal deformity. Methods Sixteen patients with bilateral cleft lip nasal deformity treated in our hospital were studied. The supporting structure of the auricle was preserved， and the C-shaped autologous conchal cartilage was prepared into a Y-shaped cartilage stent and implanted into the nasal columella. The supporting structure of alar cartilage and the shape of nasal tip were remodeled， and the effect of surgical treatment was evaluated by three-dimensional laser scanning technique. Results Sixteen patients with bilateral cleft lip nasal deformity were followed up for 1 to 2 years with satisfactory results. Postoperative patients’ satisfaction was more than 90%. The analysis of two-dimensional linear measurement showed that the height of nasal columella and nostril after operation was significantly increased than that before operation （P<0.05）， and the nasal base and breadth were significantly shorter than those before operation （P<0.05）. The comparison of three-dimensional spatial difference showed that the postoperative nasal collapse was greatly improved compared with that before operation. In the later follow-up， the shape of lip and nose is good and the effect is stable， and no secondary deformities occurred in the donor area. Conclusion Y-shaped autologous conchal cartilage transplantation for the repair of bilateral cleft lip nasal deformity is an ideal surgical method， which is worth popularizing and applying in clinic.
　　Key words： cleft lip; nasal deformity; conchal cartilage; transplantation; rhinoplasty; three dimension laser scanning; secondary deformity
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