摘要
背景：外伤致鼻基本支架塌陷后,软组织也会塌陷收缩,另外外伤损伤鼻软骨会引起鼻软骨无菌性炎症从而致部分软骨吸收,所以长期的鞍鼻畸形常伴有鼻小柱过短。外伤性鞍鼻畸形合并鼻小柱过短用医用硅橡胶矫正时张力大,易出现皮肤穿孔、破溃等并发症。目的：观察应用自体肋软骨移植修复创伤后鞍鼻畸形的效果。方法：纳入21例外伤性鞍鼻伴鼻小柱过短患者,男6例,女15例,年龄16~45岁,均有明确外伤史,对治疗方案均知情同意。取自体右侧第7肋软骨塑形成柳叶形鼻梁模型假体,鼻小柱支架修复外伤后鞍鼻畸形。在鼻小柱底部人中凹陷处行＂V-Y＂皮瓣推进缝合以延长鼻小柱。观察自体肋软骨移植修复后患者鼻畸形恢复情况,移植软骨有无排出及切口瘢痕情况等。结果与结论：自体肋软骨移植修复后患者鼻外形、鼻尖高度形态满意,鼻小柱延长,切口愈合良好,供软骨区无并发症发生。21例均获随访,随访时间6个月~2年,患者无移植软骨排出,无软骨变形,外形良好,鼻小柱底部人中凹陷处瘢痕小。提示应用自体肋软骨移植、人中凹陷处＂V-Y＂皮瓣推进缝合是修复创伤后鞍鼻畸形的理想方法。
BACKGROUND：The soft tissues would shrink with nasal framework collapse following surgical trauma,which cause aseptic inflammation,lead to parts of cartilage resorption.Accordingly,long-term saddle nose deformity usually accompanied by short nasal columella.Complications such as skin perforation or ulceration would appear if corrected the deformity using medical silicone rubber with large tension.OBJECTIVE：To explore the effectiveness of repairing post-traumatic saddle nose deformity with autologous costal cartilage transplantation.METHODS：A total of 21 cases with post-traumatic saddle nose deformity accompanied by short nasal columella were selected,including 6 males and 15 females,aged 16-45 years.All of the cases had trauma history and agreed with the treatment.The costal cartilage was obtained from the seventh rib and formed to babylon weeping willow leaf shape and columella nasi stent to repair post-traumatic saddle nose deformity.The ＂V-Y＂ progradation suture was used in the philtrum introcession and the bottom of nasal columella to extend the nasal columella.The recovery of saddle nose deformity after transplantation,discharge of transplanted cartilage,as well as the incision scar status was observed.RESULTS AND CONCLUSION：The results were satisfactory and there were no complications after transplantation.All the cases were followed up from 6 months to 2 years.No case suffered costal cartilage grafts discharge or chondral deformation.The scar was little at the bottom of nasal columella.It is an ideal method for repairing post-traumatic saddle nose deformity using transplantation of autologous costal cartilage with ＂V-Y＂ progradation suture.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第18期3363-3366,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
