隆鼻术后硅胶假体外露的原因分析

目的探讨硅胶假体隆鼻术后假体外露的原因及防治措施。方法对16例鼻假体外露患者,手术取出假体,根据假体外露部位、雕刻形态、隧道层次、切口位置等分析假体外露的原因。结果16例患者中,6例假体短臂由鼻小柱侧缘切口穿出,5例假体由鼻尖下点穿出(其中3例为柳叶型假体),3例由鼻前庭切口穿出(其中1例合并感染),2例经鼻背皮肤穿出。取出的假体形态:柳叶型假体雕刻太尖,L型假体短臂过长而长臂宽厚、假体叠加等。12例再次隆鼻,效果满意。结论假体与鼻头、鼻背不相称植入后张力过大或假体形状雕刻欠佳是外露的根本原因。因此,隆鼻术后使假体处于无张力状态及提高假体雕刻技巧是避免假体外露的主要措施。

Causal Analysis of Silicone Prosthesis Extrusion after Augmentation Rhinoplasty

Objective To investigate the causes, preventions, and treatments for silicon prosthetic extrusion after augmentation rhinoplasty. Methods All the exserted prosthesis of 16 cases were taken out by surgery. The causes of extrusion were analyzed according to the exserted sites, the prosthetic shape, layers of the tunnels as well as the incisional locations. Results The prosthetic short arms were exposed at the incision located at the lateral margin of columella nasi in 6 cases.The prosthesis were exposed at the subpoints of the nasal tips in 5 cases,including 3 prosthesis of babylon weeping willow leaf type. 3 suffered vestibule extrusion including one patient accompanied with infection. 2 were pinked at the bridge of nose. The dislodged prothesis were sculptured long short arms with wide and thick long arms, or sometimes overlapped.12 cases achieved second augmentation rhinoplasty with satisfactory effect. Conclusion Disparation between the prosthesis and the tip or back of the nose, large tension of the implantation site, or unsuitable prosthetic sculpture are the major causes of exposure.A tension-free rhinoplasty with a suitable sculptured prosthesis plays an important role in avoiding the prosthetic extrusion.