CAJ | 학술논문

目的探索唇裂术后继发鼻畸形的矫正方法,改善鼻畸形的修复效果.方法应用改良开放鼻整形切口,以鼻小柱为蒂,掀起包括健侧鼻底和前唇c瓣的前唇组织,矫正鼻小柱偏斜,延长鼻小柱.解剖出双侧鼻翼软骨,并使患侧鼻翼软骨脱套.经此切口切取鼻中隔软骨,矫正鼻中隔偏斜.部分患者另切取耳甲软骨.应用切取软骨行鼻小柱支撑缝合,加强薄弱的患侧鼻翼软骨.将患侧侧鼻软骨及鼻翼软骨分别悬吊至鼻背筋膜.缝合收拢双侧鼻翼软骨穹窿部,应用软骨行帽状移植、盾牌移植改善鼻尖形态.解剖复位异位口轮匝肌,并折叠缝合重建人中嵴,鼻翼脚松解推进重建鼻孔形态.应用软骨或去表皮瘢痕组织充填鼻底凹陷,重建鼻堤.结果 69例患者中56例均取得较好效果,鼻形态良好,鼻孔基本对称；8例患者患侧鼻底仍不够丰满,5例严重鼻畸形患者患侧鼻翼仍有轻度塌陷,鼻尖稍有偏斜.结论应用鼻整形技术矫正唇裂术后继发鼻畸形可明显改善唇裂鼻畸形修复效果.
목적 탐색진렬술후계발비기형적교정방법,개선비기형적수복효과.방법 응용개량개방비정형절구,이비소주위체,흔기포괄건측비저화전진c판적전진조직,교정비소주편사,연장비소주.해부출쌍측비익연골,병사환측비익연골탈투.경차절구절취비중격연골,교정비중격편사.부분환자령절취이갑연골.응용절취연골행비소주지탱봉합,가강박약적환측비익연골.장환측측비연골급비익연골분별현조지비배근막.봉합수롱쌍측비익연골궁륭부,응용연골행모상이식、순패이식개선비첨형태.해부복위이위구륜잡기,병절첩봉합중건인중척,비익각송해추진중건비공형태.응용연골혹거표피반흔조직충전비저요함,중건비제.결과 69례환자중56례균취득교호효과,비형태량호,비공기본대칭；8례환자환측비저잉불구봉만,5례엄중비기형환자환측비익잉유경도탑함,비첨초유편사.결론 응용비정형기술교정진렬술후계발비기형가명현개선진렬비기형수복효과.
Objective To investigate the method of aesthetically and functionally repair of the secondary cleft nasal deformity.Methods Sixty- nine cases were operated with open rhinoplasty technique with improved incision.Firstly,detach the bilateral nasal alar cartilage and upper lateral cartilage,then,harvest part of the nasal septal cartilage,correct the nasal septum deviation.Part of the patients harvest ear cartilage.Applicate nasal septal cartilage as columella strut between the medial crura,and strength the affected side nasal alar cartilage with nasal septal cartilage.Nasal alar cartilage,upper lateral cartilage were suspended and sutured to nasal dorsum fascia.Cartilage transplantation with onlay tip graft and shield - shaped graft were applicated to improve the nasal tip projection.Application of cartilage or scar tissue to fill depressions of nasal floor to reconstruct embankment.Results All patients achieved good results or near - good results with good nasal tip shape,symmetrical nostrils.Nasal floor of several patients is far from full.Conclusions The correction of the secondary cleft nasal deformity using cartilage suspended technique,columellar struts,surure techniques,tip grafts is aesthetically improved.