鼻尖整形83例的临床体会(1)
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[摘要]目的：回顾和总结83例鼻尖整形术的临床经验。方法：根据双侧鼻尖表现点间距不同，在术前将患者分为3型，并有针对性地采用不同的手术技术。我们将改良的软骨雕刻方法和鼻尖部脂肪结缔组织瓣转移的方法与传统的技术(如软骨缝合技术、鼻翼软骨外侧脚头侧部分切除等)巧妙地结合来改善鼻尖的形态。临床应用83例。结果：本组患者随访10～60个月，鼻尖形态改善明显，远期效果稳定，无并发症，满意率达96.4%。结论：本法适用于鼻尖圆钝的患者。
[关键词]鼻尖整形；缝合技术；软骨移植；脂肪结缔组织瓣
[中图分类号]R622R765.9[文献标识码]A[文章编号]1008-6455(2011)01-0041-03
Clinical experience of nasal tip plasty in 83 cases
WANG Tai-ling1, MA Ji-guang2, YANG Xin2, WANG Jia-qi3, ZHANG Hai-ming3, GUO Xin3
(1.The 6th Department of Plastic Surgery Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100144, China; 2. The Ping'an Clinic of Plastic Surgery Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100035, China; 3. The 3rd Department of Plastic Surgery Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100144, China)
Abstract：ObjectiveTo review and summary the clinical experience of nasal tip plasty in 83 cases.MethodsAccording to the distance between both tip-defining points, we classified the patients into three types and used different techniques accordingly. In order to reshape the tip contours, an innovative cartilage carving method and a tip fibro-fatty tissue flap were designed and combined with traditional techniques, such as suture techniques and cephalic trimming. 83 patients were treated.ResultsThe follow-up period ranged from 10 to 60 months. Remarkable improvements in nasal tip contours were achieved. The outcomes remained unchanged over time. No complications appeared in any of the 83 patients. The satisfaction rate is 96.4%.ConclusionsOur method was effective and suitable for bulbous nasal tips.
Key words：nasal tip plasty; suture techniques; cartilage grafts; fibro-fatty tissue flap
鼻整形手术作为近年来整形手术的热点领域，被越来越多的医生所重视。中国人接受鼻整形手术主要原因是低鼻背和鼻尖圆钝。虽然硅胶假体隆鼻术已经应用多年，但单纯靠硅胶假体提高鼻尖高度，只会增加假体顶出率。近年，软骨移植物充填、软骨缝合和鼻翼软骨切除等技术[1]在临床中得到不同程度的应用，但如何将这些技术合理地应用于不同类型的患者，尚无合适理论。2002～2007年，我们治疗鼻尖圆钝的患者83例，取得了比较满意的效果。
1临床资料
临床患者83例(男性12例，女性71例)，年龄21～36岁(平均27岁)。均为初次手术患者。根据双侧鼻尖表现点间距，我们将83位患者分成3型：1型(6mm-≤8mm)；2型(>8 mm-≤10mm)；3型(>10mm)。我们又根据鼻尖软组织厚薄不同，进一步分成了6个亚型，并依此选择不同技术(表 1)。
2 手术方法
2.1 局麻药浸润麻醉(0.5%利多卡因混和 1:200 000 肾上腺素)，局麻药内也可加入曲安奈德10mg，以减少术后肿胀和瘢痕。取双侧鼻翼软骨下缘切口 ......
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