摘要目的 探索有效整复软骨性歪鼻(a tilted or bent cartilaginous vault)的方法.方法 对鼻中隔偏斜和不同程度的通气障碍的软骨性歪鼻18例,全部采用开放入路,行鼻中隔畸形部软骨切除术+鼻中隔软骨扩展移植鼻尖成形术.结果 随访3～24个月,除1例鼻中隔仍有轻微度偏曲(不影响功能)外,其余均鼻梁端正,鼻中隔居中.术后通气功能均有明显改善,鼻外形及鼻尖形态满意.无1例发生外鼻畸形及鼻中隔穿孔.结论 软骨性歪鼻在行鼻成形术的同时行鼻中隔偏曲矫正术是极其必要的,既可消除引起软骨性歪鼻畸形的原因,又可取得外鼻形态满意的效果.

abstractsObjective To seek a method to correct the bent cartilaginous vault.Methods This study included 18 patients (12 women,6 men,aged 18-45 years) suffering from the bent cartilaginous vault with the various degrees of nasal obstruction from January 2005 to December 2009.A open surgical approach was adopted to allow correction of the dorsal and caudal deviations of the nasal septum without weakening its structural support to the dorsum or nasal tip.The approach depended on full mobilization of deviated cartilage,removal of the deviated part of the quadrangular cartilage,followed by straightening of a caudal septal extension graft and its fixation in the corrected position.Rhinoplasty was performed to correct bent cartilaginous vault.Results A satisfactory result was gained in all clinical cases,except a septum still to remain light tilt (not affect the breathing function).Follwing-up for 3-24 months,all cases dorsum of nose was straighten and nasal septum situated mediately.All patients indicated cosmetic satisfaction of nasal dorsum and tip and improvement in nasal obstruction.No nasal deformity and septum tresis was found in all patients.Conclusions ()pen rhinoplasty is a helpful technique in the treatment of the bent cartilaginous vault.Septal surgery is necessary in the patients with cartilage framework,not only to improve breathing but also to achieve a straight,symmetrical and external nose as well.