单侧完全性唇裂鼻畸形早期整复的回顾性研究

目的 对单侧完全性唇裂患儿早期鼻畸形整复的手术效果进行回顾性研究,为唇裂鼻畸形整复提供一种治疗思路。方法 选取于西安交通大学口腔医院就诊的24例单侧完全性唇裂患儿为研究对象,唇裂整复手术同期行鼻畸形整复,重建鼻基底,矫正鼻中隔,整复鼻翼部畸形。术后1周开始佩戴鼻模。评价术前、术后1周及术后1年鼻部形态。结果 术后1周、术后1年患者的患/健侧鼻孔高度比、健/患侧鼻底宽度比、患/健侧鼻翼角度比、鼻小柱偏斜角度与术前相比,差异有统计学意义（P<0.05）;术后1年患者的患/健侧鼻孔高度比、鼻小柱偏斜角度与术后1周相比,差异有统计学意义（P<0.05）。结论 单侧完全性唇裂早期鼻畸形整复可获较好的鼻部形态,尽管术后会有一些复发,但对称性仍优于术前,鼻部形态可以得到很好的矫正和维持。     

两类单侧不全唇裂鼻畸形临床特点的初步研究

目的：研究单侧不全唇裂伴有／和不伴有牙槽突裂患儿的唇、鼻部畸形特征。方法：对68例患者进行唇鼻部相关数据的测量研究,采用改良Mohler术式修复唇裂并同期矫正鼻畸形。结果：术前测量显示伴有牙槽突裂患儿的唇峰～鼻翼,唇峰～鼻小柱基底的距离,鼻孔高,鼻孔宽和鼻小柱高度与不伴有牙槽突裂的患儿相同指标有显著性差异。结论：通过测量数据的分析显示：单侧不完全性唇裂伴有牙槽突裂是一种畸形更为严重的不全唇裂。     

单侧完全性唇裂修复术同期矫正鼻畸形疗效观察

目的探讨婴幼儿单侧完全性唇裂I期修复术同期矫正鼻畸形的手术方法、可行性及其疗效。方法对5l例单侧完全性唇裂患儿采用Millard I或Ⅱ式手术方法修复唇裂,同期对其鼻畸形进行初步矫正,包括：恢复患侧鼻翼脚的水平高度,使之与健侧对称;重建患侧鼻底形态;延长患侧的鼻小柱长度;恢复患侧鼻嵴和鼻孔大小;鼻外形均得到改善。结果所有患儿均随访36～48个月,患侧鼻翼外侧脚上提内移,鼻小柱变长。所有患儿均未明昆增加术后瘢痕,随访期间均未出现患侧鼻翼发育障碍所致畸形加重。结论单侧完全性唇裂患儿均伴有较严晕的鼻畸形,在I期唇裂修复术同期矫正鼻畸形可以在不增加附加切口的情况下,获得更佳的畸形矫正疗效,患儿术后鼻部的美观和对称性可得到进一步改善,对患侧鼻部的发育未见明显影响。     

鼻齿槽矫正及鼻模塑形对单侧完全性唇裂鼻畸形矫治效果的临床研究

目的：客观定量分析评价术前鼻牙槽塑形矫治器（PNAM）及术后鼻模佩戴对单侧完全性唇裂患者鼻畸形的临床矫治效果。方法：选择符合纳入标准的3组病例48例,A组（10例）出生2周内佩戴PNAM矫治器,矫治3个月后行唇裂修复手术,术后即佩戴鼻模塑形,且佩戴周期半年以上。B组（12例）未进行PNAM矫治治疗,术后即佩戴鼻模塑形半年以上。C组（26例）单纯行唇裂外科手术修复。3组病例均由同一术者用改良台湾长庚法修复唇裂畸形及鼻畸形。通过对3组病例术后1年正仰面照片的标记与测量,并对测量结果进行多元方差分析,客观评价术前PNAM矫治及术后佩戴鼻模对单侧完全性唇裂鼻畸形的矫治效果。结果：A组术后1年鼻小柱偏离程度、鼻底宽度对称率、鼻底高度对称率、鼻基部长度与B、C组比较差异均有统计学意义,但术后1年的鼻偏曲度改善无统计学意义。结论：单侧完全性唇裂鼻畸形患儿在婴儿早期行PNAM矫治及术后佩戴鼻模对鼻畸形外形的改善有非常明显的作用,是早期有效改善患者鼻唇部原发畸形的治疗方法,为唇腭裂的序列治疗提供了有效的补充。     

单侧完全性唇腭裂患儿鼻牙槽塑形术后3年临床效果分析

目的    通过对单侧完全性唇腭裂患儿鼻牙槽塑形（PNAM）治疗前及术后3年鼻部对称性的测量,分析PNAM治疗术后3年的临床效果。方法    选择2011年2月至2011年6月于西安交通大学附属口腔医院进行PNAM治疗的15例单侧完全性唇腭裂患儿,从PNAM治疗前至治疗后3年分为4个时间点：初次就诊（T0）、PNAM治疗结束（T1）、唇裂修复术后（T2）和治疗后3年（T3）;拍摄正位和仰90°面部照片,在照片中标记12个鼻部标志点,进行16项测量。结果    与T0进行相比,T1鼻背倾斜度和鼻小柱倾斜度明显减小（均P＜0.05）;与T1相比,T2鼻背倾斜度、鼻小柱倾斜度、患侧与健侧鼻翼高度比、患侧与健侧鼻底高度比、鼻底与内眦连线比均明显减小（均P＜0.05）,患侧鼻翼顶与鼻底高度比明显增大（均P＜0.05）;与T2相比,T3鼻小柱倾斜度有复发,其余测量指标差异均无统计学意义（均P＞0.05）。结论    PNAM治疗可明显改善患儿鼻部对称性,鼻部形态在术后3年仍保持稳定。     

新生儿唇腭裂术前鼻部矫正效果的初步评价

目的:应用鼻翼-牙槽改建矫治器对唇腭裂新生儿进行早期鼻部治疗,观察该矫治器对鼻翼、鼻小柱的矫治效果。方法:10例在早期行鼻翼-牙槽改建的唇腭裂患儿作为治疗组,10例未经任何术前矫正者作为对照组。在矫正前(T0)、唇裂术前(T1)、术后2周(T2)、术后半年(T3)分别拍摄鼻部照片,用配对t检验分析比较鼻翼、鼻小柱的对称性。结果:治疗组T0-T1、T1-T2,两侧鼻不对称率减小(P<0.05),T2-T3两侧鼻不对称率增大(P<0.05)。治疗组与对照组手术前后鼻不对称率的改变值在垂直方向上有显著差异(P<0.01),水平方向上差异无统计学意义(P>0.05)。结论:鼻翼-牙槽改建矫治器可明显改善鼻部对称性;术后半年,患侧鼻部有复发趋势,但其鼻翼拱形仍较理想。     

鼻牙槽骨塑形对单侧完全性唇腭裂患儿术后鼻外形的影响

目的：探讨术前鼻牙槽骨塑形矫治对单侧完全性唇腭裂患儿术后长期鼻外形美观与对称性的影响。方法：84例患儿按改良式旋转推进唇裂修复术实施手术。其中，经过术前鼻牙槽骨塑形矫治42例，未经术前鼻牙槽骨塑形矫治42例。均采用术后4～5a照片打分方式进行鼻外形评定，而后分组进行比较。采用SPSS10．0软件包进行配对样本t检验。结果：经过术前鼻牙槽骨塑形矫治和未经术前鼻牙槽骨塑形矫治患儿，术后4～5a鼻外形的美观与对称性平均得分分别为66．62±14．25和66．31±15．08，两者之间无显著统计学差异（P〉0．05）。结论：单纯术前应用鼻牙槽骨塑形矫治纠正单侧完全性唇腭裂患儿鼻畸形，而未对单侧唇裂鼻畸形形成的解剖学机制进行有效干预，手术后良好的鼻外形无法长期维持。     

植入物加强鼻小柱支撑修复唇裂鼻畸形

植入物加强鼻小柱支撑修复唇裂鼻畸形第一军医大学南方医院口腔科（５１０５１５）姚小武，钟永持，李少萍唇裂修复术后唇部畸形可得到满意的矫正，但鼻部畸形的矫正都不尽人意。随着年龄的增长，鼻部畸形更为突出。近年来这个问题受到广泛的重视。作者采用加强鼻小柱支撑...     

唇裂修复旋转推进法与三角瓣法术后鼻畸形改变的比较

为了比较唇裂修复的不同方法——旋转推进法和三角瓣法对鼻畸形的改善，作者以仰头位面像为分析资料，随机抽取１２６例在该院由同一术者行唇裂修复的单侧唇裂术后患者为样本，其中行三角瓣法６８例，旋转推进法５８例，术后平均复诊时间４．７年。通过测量，对比健患侧鼻翼基部、鼻底宽度、鼻小柱高度、鼻孔面积的对称情况以及鼻小柱偏斜情况，发现旋转推进法术后鼻畸形得到改善，但患侧鼻孔面积减小，使其鼻畸形二期修复更加困难；三角瓣法术后鼻畸形几乎无改善，但其造成患侧鼻孔面积过小的机会少，鼻畸形二期修复比较容易。     

唇裂术后鼻部对称性的变化及其影响因素

目的 评价华西法修复单侧完全性唇裂术后鼻底宽度及其对称性的变化以及与裂隙宽度的关系,为一期手术鼻畸形整复提供参考.方法选择应用华西法修复单侧完全性唇裂患者27例,分别于术前、术后1周及术后1年拍摄面部正位照片,测量鼻小柱中点偏离程度、鼻底宽度及裂隙宽度,计算鼻小柱中点回归率、鼻底宽度对称率和鼻底宽度变化,并采用SPSS...     

The influence of nasal patency on accelerometric transduction of nasal bone vibration

The transmission characteristics of nasal tract energy to a nasal accelerometer were evaluated in relation to nasal tract airway resistance. Ten adult speakers repeated three utterances while recordings of nasal bone vibration, as detected by miniature accelerometers, were obtained simultaneously from both sides of the nose and referenced to a common throat signal. Average nasal-to-oral accelerometry ratios recorded from the more resistant side of the nose were significantly larger in magnitude than those recorded simultaneously from the less resistant side of the nose. While accelerometer ratio waveforms from each side of the nose essentially overlapped for some subjects, others displayed unilateral variations in accelerometer output as a function of time. The anatomic and physiologic condition of the nasal passage appears to be an important variable in the detection of nasal tract acoustic energy using the accelerometric technique.     

鼻缺损修复CAD/CAM系统的开发——汉族人三维标准外鼻形态数据库的建立

目的:提供具有汉族人群标准数值的多种形态的三维数字外鼻,建立标准鼻型数据库,以满足鼻缺损患者赝复的需要。方法:采集30岁以下男女的6种类型共12个外鼻,取模,灌超硬石膏模型,然后通过三维激光扫描测量系统转换为.asc格式的三维数字化模型。将数字模型按照解剖形态分为6区构面,添加颜色进行可视化显示,以.igs格式保存。在SUrFACER10.5软件中重现各鼻.asc格式的三维图形,测量鼻长、鼻宽,然后用张万洲1011个汉族成人鼻鼻长、鼻宽的活体测量结果,取代.asc和.igs格式各鼻鼻长、鼻宽的测量结果,将数据存盘。结果:得到12个大小一致的标准外鼻的点云构型文件和曲面构型文件以及各自的二维图片,分别按照6类理想鼻型以树状结构存盘。结论:构建了三维标准外鼻形态数据库,为鼻缺损修复CAD/CAM系统的应用奠定了基础。     

Estimation of nasal cross-sectional areas, using oral versus nasal pressure measurements

This study examines calculations of model nasal cross-sectional area, using nasal versus oral pressure measurements. The results indicate that greater accuracy of nasal cross-sectional area estimation is achieved by using nasal rather than oral pressures. Nasal pressures measured in the anterior model nose more closely reflect nasopharyngeal pressures under a wide range of nasal constriction sizes and airflow rates.     

Improved nasal tip projection in the treatment of bilateral cleft nasal deformity

The cleft nose deformity in bilateral cleft lip and palate patients with severely flattened alar cartilages, a short, scarred columella, and thickened skin is a reconstructive challenge. The Wolfe double-arch tip rhinoplasty technique was compared with a cartilage release and tip grafting technique to determine the optimal modality for tip projection and columella lengthening. Patients with significant bilateral cleft nasal deformities and previous bilateral cleft lip repairs were divided into two groups (n = 22). Group 1 (double-arch) patients underwent an open rhinoplasty using conchal cartilage grafts to create a columellar strut and new lower lateral arches placed over the existing arches (n = 12). In group 2 (release and tip graft), the lower lateral cartilages were released, and nasal tip grafting was performed (n = 10). Preoperative and 6-month postoperative measurements, including (1) columellar length, (2) alar base-nasal tip-columellar base (ATC) angle, and (3) lateral tip projection, were compared. The lateral tip projection is the perpendicular distance between the nasal tip and a line created from the connection of points at the nasion to the subnasale. In group 1 (double arch), the mean columella length increased 47.2%, whereas in group 2 (release and tip graft), it only increased 14.1%. The ATC angle had a mean decrease or narrowing of 26.7 degrees in group 1, compared with a 12.5 degrees decrease in group 2. Lateral tip projection improvement was greater in group 1 (52.2% increase) compared with group 2 (19.9% increase). The authors' data showed that for the difficult bilateral cleft nasal deformity with significant tip flattening, the double-arch tip rhinoplasty provides improved nasal tip projection.     

The relationship between nasal airway cross-sectional area and nasal resistance

Mouth breathing in response to an impaired nasal airway is thought to have clinical consequences. Physiologically, mouth breathing occurs whenever the body senses that nasal resistance is inappropriately high. In physical terms mouth breathing is a response that enlarges the upper airway and, by doing so, reduces airway resistance. In the past measurements of nasal resistance have been used as an index of airway impairment. Recently, we introduced a technique that estimates cross-sectional size of the airway, a variable that directly determines the magnitude of airway resistance. The purpose of the present study was to determine the precise effects of nasal airway size on nasal airway resistance so that the relationship between the two could be described in mathematic terms. There were two phases to the study--one involving a model and simulated breathing, and the other involving 100 subjects demonstrating normal and impaired nasal airways. The pressure-flow technique for estimation of nasal airway size and nasal airway resistance was used. The following equation was generated from the data: Resistance = 1.9 + (Formula: see text). The relationship between the two variables is nonlinear--that is, size of the airway has its greatest effect on resistance when the airway is less than 0.4 cm2 and a much lesser effect at larger airway sizes. The study also showed that nasal airway resistance generally does not fall very much below 1.9 cm H2O/L/S during breathing even when the airway is very large. This probably relates to the need to maintain an adequate level of airway resistance for alveolar gas exchange.(ABSTRACT TRUNCATED AT 250 WORDS)     

Application of nasal clip in the one-stage repair of unilateral cleft lip nasal deformity

目的 探讨鼻夹在单侧唇裂鼻畸形一期整复术后的应用效果。方法 选取2017年1月—2018年6月在四川大学华西口腔医院唇腭裂外科行单侧唇裂鼻畸形一期整复术的患者60例,分为鼻夹组、鼻模组和对照组。3组患者均在术后6~12个月复诊,并对鼻外形进行评价。结果 鼻夹组患者的鼻外形发育及美学效果较对照组有明显改善,差异有统计学意义（P<0.05）。结论 鼻夹对于唇裂鼻畸形患者矫正术后鼻外形的改善有良好的效果,而且鼻夹操作简单,患者依从性较好,值得临床推广使用。     

小鼠鼻软骨细胞的培养

目的 天空小鼠鼻软骨细胞体外培养方法及形态特征。方法 取Balb/c小鼠子鼠的鼻中隔软骨，随机分为4组分别消化4h,8h,12h及16h，观察体外培养软骨细胞的生长状况，并用Ⅱ型胶原抗体进行细胞来源鉴定。结果 经Ⅱ型胶原酶孵育消化4h的组织，细胞量少，生长缓慢，无法进行正常传代。而消化8h的软骨组织、细胞于1d后即开始贴壁、伸展，9d第一次传代，传代细胞生长稳定，形态多样，Ⅱ型胶原抗休染色体阳性。消化2h及16h的细胞几乎不贴壁。结论 采用酶消化法可获得体外培养的小鼠鼻软骨细胞，消化时间以8h为佳。