综合鼻整形术中自体耳软骨对鼻头支撑重塑的应用研究(1)
[摘要]目的：探讨综合鼻整形术中采用耳软骨重塑鼻头支架结构，达到延长或抬高鼻头，获得鼻外形整体改善的良好美学效果。方法：对笔者医院2015年6月-2017年6月收治的635例要求行鼻综合整形的就医者为研究对象，采取自体单侧耳软骨，根据鼻部具体矫治所需进行雕刻塑形后，进行鼻头支架结构的重塑；同时，结合柳叶形假体对鼻部实施隆鼻术，综合手段整体塑造美学形态良好的鼻部外观。结果：本组635例就医者，术后随访3个月～2年，总体满意度较高，鼻外形美观自然。术后并发感染1例，鼻部明显歪斜1例及鼻尖过长2例，处理后获良好效果。供区愈合良好，耳廓外形无明显改变。结论：采用自体耳软骨对于有缺陷的鼻头部支架结构进行重塑，可达到最符合美学解剖特点的缺陷矫治效果，基于此基础同时行鼻假体隆鼻，最终获得了相对完美的全鼻美学形态。
[关键词]综合鼻整形；自体耳软骨；鼻头；重塑；假体隆鼻术
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2018)07-0001-03
, http://www.100md.com
Abstract： Objective To discuss and summarize the good aesthetic effect of remodeling the nasal tip with autogenous ear cartilage in synthetic rhinoplasty. Methods 635 patients who required comprehensive rhinoplasty in our hospital form June 2015 to June 2017 were selected as research subjects. The patients were treated with synthetic rhinoplasty. The fist，they were remodeled the nasal tip by unilateral autogenous ear cartilage implantation. Meanwhile， prosthesis augmentation rhinoplasty were accepted. And then， they were adjusted the nosewings. Results All 635 patients were followed up for 3 months to 2 years， most of all cases were satisfied with the cosmetic effect， the nose looks beautiful and natural. One patient was occurred postoperative infection after 2 months， One patient’s nose was obviously skewed and two cases with nasal tip too long were all adjusted and corrected for 6 months after the surgery， and finally achieved good results. The area healed were well and the auricle shapes were not changed significantly. Conclusion It can achieve good correction effects of the most suitable for the aesthetic anatomical features using autogenous ear cartilage to reshape the framework of defective nose， and combined with the nasal prosthesis rhinoplasty， eventually obtaining relatively perfect aesthetic nose.
, 百拇医药
Key words： synthetic rhinoplasty； autogenous ear cartilage； nasal tip； remodeling； augmentation rhinoplasty
鼻居于面部正中，不僅是呼吸系统中人体与外部空气交换的重要器官，而且无论在中国的面相学里还是西方医学面部解剖构造中，都是面部美学最关键的组成部分，其外部形态对于面貌美观起着至关重要的作用，所以自整形美容手术兴起之初，鼻整形就成为美容就医者最主要的求治需求之一[1-2]。临床上除了常见的基于鼻根部低平采用的L形或柳叶形假体隆鼻术外，随着医患双方对于美学效果要求的日臻完美，鼻尖低、鼻小柱短小、鼻翼塌陷、宽大或左右不对称、鼻孔外露(朝天鼻)等，越来越受到就医者的重视。既往采用的单纯隆鼻术不能达到理想的矫治效果[3]，为了达到效果良好的矫治效果，采用综合鼻整形术成为对这类就医者最重要的矫治手段。对笔者医院2015年6月-2017年6月收治的635例要求行鼻综合整形术的就医者，采用假体隆鼻+自体耳软骨鼻部支架重构+鼻翼调整的手段进行矫治，获得了满意效果，现报道如下。
1 临床资料
选择笔者医院2015年6月-2017年6月收治的635例行鼻综合整形术的就医者为研究对象，存在如鼻背低平、鼻头塌陷、鼻翼两侧不对称、鼻孔外露、鼻头肥大、鼻小柱过短等症状，所有就医者术中都采用单侧耳软骨修整鼻头。其中，男39例，女596例；年龄18～52岁；初次手术者496例，二次手术者139例，二次手术者主要为原先曾行单纯假体隆鼻手术，保留鼻中隔软骨未行综合鼻整形手术者。手术主要采取柳叶形假体隆鼻+单侧耳软骨+鼻头调整，其中195例辅以宽鼻缩窄术，286例辅以鼻翼缩小手术，同时行宽鼻缩窄手术+鼻翼缩小手术者108例。, http://www.100md.com(叶丽萍 赵天兰)
[关键词]综合鼻整形；自体耳软骨；鼻头；重塑；假体隆鼻术
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2018)07-0001-03
, http://www.100md.com
Abstract： Objective To discuss and summarize the good aesthetic effect of remodeling the nasal tip with autogenous ear cartilage in synthetic rhinoplasty. Methods 635 patients who required comprehensive rhinoplasty in our hospital form June 2015 to June 2017 were selected as research subjects. The patients were treated with synthetic rhinoplasty. The fist，they were remodeled the nasal tip by unilateral autogenous ear cartilage implantation. Meanwhile， prosthesis augmentation rhinoplasty were accepted. And then， they were adjusted the nosewings. Results All 635 patients were followed up for 3 months to 2 years， most of all cases were satisfied with the cosmetic effect， the nose looks beautiful and natural. One patient was occurred postoperative infection after 2 months， One patient’s nose was obviously skewed and two cases with nasal tip too long were all adjusted and corrected for 6 months after the surgery， and finally achieved good results. The area healed were well and the auricle shapes were not changed significantly. Conclusion It can achieve good correction effects of the most suitable for the aesthetic anatomical features using autogenous ear cartilage to reshape the framework of defective nose， and combined with the nasal prosthesis rhinoplasty， eventually obtaining relatively perfect aesthetic nose.
, 百拇医药
Key words： synthetic rhinoplasty； autogenous ear cartilage； nasal tip； remodeling； augmentation rhinoplasty
鼻居于面部正中，不僅是呼吸系统中人体与外部空气交换的重要器官，而且无论在中国的面相学里还是西方医学面部解剖构造中，都是面部美学最关键的组成部分，其外部形态对于面貌美观起着至关重要的作用，所以自整形美容手术兴起之初，鼻整形就成为美容就医者最主要的求治需求之一[1-2]。临床上除了常见的基于鼻根部低平采用的L形或柳叶形假体隆鼻术外，随着医患双方对于美学效果要求的日臻完美，鼻尖低、鼻小柱短小、鼻翼塌陷、宽大或左右不对称、鼻孔外露(朝天鼻)等，越来越受到就医者的重视。既往采用的单纯隆鼻术不能达到理想的矫治效果[3]，为了达到效果良好的矫治效果，采用综合鼻整形术成为对这类就医者最重要的矫治手段。对笔者医院2015年6月-2017年6月收治的635例要求行鼻综合整形术的就医者，采用假体隆鼻+自体耳软骨鼻部支架重构+鼻翼调整的手段进行矫治，获得了满意效果，现报道如下。
1 临床资料
选择笔者医院2015年6月-2017年6月收治的635例行鼻综合整形术的就医者为研究对象，存在如鼻背低平、鼻头塌陷、鼻翼两侧不对称、鼻孔外露、鼻头肥大、鼻小柱过短等症状，所有就医者术中都采用单侧耳软骨修整鼻头。其中，男39例，女596例；年龄18～52岁；初次手术者496例，二次手术者139例，二次手术者主要为原先曾行单纯假体隆鼻手术，保留鼻中隔软骨未行综合鼻整形手术者。手术主要采取柳叶形假体隆鼻+单侧耳软骨+鼻头调整，其中195例辅以宽鼻缩窄术，286例辅以鼻翼缩小手术，同时行宽鼻缩窄手术+鼻翼缩小手术者108例。, http://www.100md.com(叶丽萍 赵天兰)
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