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3D技术辅助自体软骨移植矫正鼻软三角畸形的效果

Application of autogenous cartilage transplantation in correction of nasal soft-tissue triangle deformities aided by 3D technology

摘要目的:评估3D技术辅助下自体软骨移植在鼻软三角畸形矫正术的效果。方法:选取2016年1月至2018年1月南京中医药大学附属医院整形外科32例鼻软三角畸形患者,男7例,女25例,年龄18~42(28.5±6.8)岁;取肋软骨、鼻中隔软骨或耳软骨,雕刻成条块状,用作鼻翼缘移植物,重建穹隆外形,矫正鼻软三角畸形;将肋软骨或鼻中隔软骨用作鼻小柱支撑移植物,并移植假体垫高鼻背,鼻尖移植筋膜组织以缓解张力。对比手术前后鼻部外形变化,软骨移植前后鼻翼软骨内外脚夹角变化,及鼻孔长轴到鼻翼缘最大距离差异,评估鼻软三角畸形矫正疗效。结果:32例患者鼻翼软骨内外脚夹角术前为(51.5±10.9)°,术后降为(37.2±5.9)°,差异有统计学意义( P<0.05);鼻孔长轴到鼻翼缘最大距离术前为(3.3±0.6) mm,术后降为(1.9±0.7) mm,差异有统计学意义( P<0.05)。术后随访6~18个月,鼻部外观及触感自然,无严重并发症,疗效满意度为87.5%(28/32)。 结论:在3D技术辅助下,自体软骨移植修复鼻软三角畸形,术后鼻部形态改善良好,疗效满意度高,是一种较理想的手术方法。

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abstractsObjective:To evaluate the curative effect of autogenous cartilage transplantation in the correction of nasal soft-tissue triangle deformities aided by 3D technology.Methods:From January 2016 to January 2018, 32 patients with nasal soft-tissue triangle deformities were collected, with 7 males and 25 females, aged from 18 to 32 years (mean 28.5±6.8 years). A part of the costal cartilage/nasal septum cartilage or auricular cartilage was cut as repair material, which was carved into strips, and used as nasal alar rim grafts to reconstruct the dome shape and correct the nasal soft triangle deformities. The costal cartilage or nasal septum cartilage was used to strengthen the support of the columella nasi and augmentation rhinoplasty was performed with prosthesis, and the fascia was placed on nose tip to relieve tension. The surgical results were evaluated by comparing the pre- and post-operative images; statistical analysis was conducted to compare the difference of alar cartilage angle along inside and outside implants before and after the fornix reconstruction, and the difference of maximum distance from the nostrils long shaft to the nose flange between pre- and post-operation, and so the effect of nasal soft triangular deformity correction was evaluated.Results:The alar cartilage angle of the 32 patients was (51.5±10.9)° before surgery, and decreased to (37.2±5.9)° after surgery; the difference was statistically significant ( P<0.05). The maximum distance from the nostrils long shaft to the nose flange was (3.3±0.6) mm before surgery, and it reduced to (1.9±0.7) mm after surgery; the difference was statistically significant ( P<0.05). The patients were followed up for 6 to 18 months, and the result showed that the curative effect was significant, with good appearance and natural feeling, and there were no serious complications, and the satisfactory rate was 87.5%. Conclusions:Autogenous cartilage is used to repair nasal soft-tissue triangle deformities aided by 3D technology; the nasal morphology is improved delicately, and the postoperative satisfaction of curative effect is high, which is an ideal surgical method.

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