中国人功能性鼻整形手术的思考

为了探讨适合中国人的功能性鼻整形手术方法,本文归纳总结了中国人鼻部解剖支架特点、鼻部美学特征与白种人和韩国人的区别,结合鼻部解剖支架结构及其功能,分析比较了目前国内外主流的几种功能性鼻整形手术方法的优缺点。提倡用简单微创的方法,按照中国人鼻部美学特征来个性化设计和实施功能性鼻整形手术,手术目的首先强调鼻呼吸功能改善,其次是与面部和谐的鼻外形改善。     

功能性鼻整形手术的相关解剖进展北大核心CSCD

鼻部支架是由上1/3的骨性支架和下2/3的软骨支架构成的三棱锥体结构,是鼻外形和功能的解剖结构基础。功能性鼻整形手术主要通过调整骨和软骨性支架的异常,达到外形和功能的同期改善。本文介绍了外鼻美学特征、鼻部皮肤软组织结构、鼻部支架(包括骨和软骨性鼻锥)、鼻小叶和鼻腔,并提出鼻背软骨的概念,对键石区在功能性鼻整形中的作用有了新的认识,强调了隔背软骨的重要性。功能性鼻整形手术前,要准确定位引起表面标志异常和通气功能障碍的解剖部位,精准手术,才能获得患者和医生均满意的效果。     

功能性鼻整形解剖学基础及进展

鼻整形按照手术目的可以分为美容性鼻整形和功能性鼻整形。功能性鼻整形是通过调整鼻部框架结构来改善鼻子的通气功能,手术过程中,外观也会发生改变。常见的功能性鼻整形病种有歪鼻、尾段鼻中隔偏曲、陈旧性鼻骨骨折、鼻软骨畸形、内外鼻瓣的塌陷和狭窄等。现将对功能性鼻整形的解剖学基础与进展作一综述,以提高对功能性鼻整形的认识。     

鼻整形相关功能问题探讨北大核心CSCD

功能性鼻整形主要通过改变解剖结构进而改善鼻腔通气功能,实现外形和功能的统一,其中既包括异常结构的矫正,也包括正常结构的保护。本文结合近年发表的文献和临床实践,对鼻部结构与功能的关系、鼻部结构与外形的关系、鼻整形术对鼻腔通气功能的影响,以及保留性鼻整形等方面进行阐述,以期提高读者对鼻整形相关功能、尤其是鼻阻塞问题的理解和认识。     

鼻整形相关功能问题探讨

功能性鼻整形主要通过改变解剖结构进而改善鼻腔通气功能, 实现外形和功能的统一, 其中既包括异常结构的矫正, 也包括正常结构的保护。本文结合近年发表的文献和临床实践, 对鼻部结构与功能的关系、鼻部结构与外形的关系、鼻整形术对鼻腔通气功能的影响, 以及保留性鼻整形等方面进行阐述, 以期提高读者对鼻整形相关功能、尤其是鼻阻塞问题的理解和认识。     

自体肋软骨移植联合硅胶隆鼻术在鼻部美容整形修复中的应用研究

目的对于自体软肋骨移植与硅胶隆鼻术进行联合的美容整形修复效果的分析研究。方法选择在我院进行整容的14例女性,根据这些女性的自身条件分成两个组,为了使研究的结果明显,将两个组放入的人数一样。并且为对照组的女性只使用硅胶材料进行鼻部整容,但是观察组的女性使用的是本次研究的方法进行鼻部整形。之后对比两组女性术后的伤口愈合程度以及是否会出现其他并发症,另外让两组女性对整容的结果满意度进行评价。结果通过分析数据可以得出,观察组女性的术后伤口恢复的情况比对照组要好许多,并且恢复的时间也比对照组的短。而且观察组术后出现并发症的情况也少于对照组,对于整形的满意程度也高于对照组。结论本次研究的鼻部整形的方法效果非常的好,不仅满足了整容人对于美的追求,术后恢复的也非常快并发症的发生概率也比较的少,所以值得各大医美医院推广使用。     

功能性鼻整形的解剖学进展

随着整形外科技术的不断发展,功能性鼻整形外科因其需要同时改善患者鼻部的外观及功能而受到广泛关注。本文旨在梳理近年来功能性鼻整形领域的解剖学进展,对鼻部与功能相关的重要结构的解剖学研究进行回顾,为功能性鼻整形临床研究与实践提供理论基础和参考。     

3D打印在功能性鼻整形手术中的应用

功能性鼻整形手术是一种恢复或改善鼻的形状和功能的手术,在术中常用到植入或非植入性材料。3D打印是材料制造行业的一次技术革新,近年来在包括生命医学的多个科学领域发展迅猛。3D打印具有个性定制、精确制作的特点,这恰好与个体化需求明显的功能性鼻整形手术契合。本文就3D打印在功能性鼻整形手术术前规划和学习、术中辅助操作和引导、植入物等方面的研究和应用进行综述,并将应用3D打印与传统方法的功能性鼻整形手术进行对比,同时展望3D打印在该领域的未来发展。     

患者报告结局量表在鼻整形术中的应用

鼻整形手术较复杂且患者通常期望值较高,多种因素影响了术后疗效的判定。医患双方若能在手术前后客观评价鼻部情况,将对提高患者的满意度大有裨益。本文详细归纳了与鼻整形术相关的患者报告结局量表在围手术期中的应用,总结各种量表的特性并进行评价,以期为鼻整形术后疗效评估提供参考。     

鼻综合整形手术病人中耳软骨的应用意义探讨

目的 研究鼻综合整形手术患者中应用耳软骨的效果。方法 数据遴选本院2019年1月-2021年11月收治的48例鼻综合整形手术患者,“手术使用材料差异”分硅胶组(硅胶,n=24)、研讨组(耳软骨,n=24),2组疗效比较。结果 治疗前比较2组临床指标无差异,P>0.05;治疗后与硅胶组比较,研讨组鼻唇角、鼻梁偏斜角更低,鼻额角、鼻尖突出度更高;手术、住院时间更短;研讨组满意率(95.83%)高于硅胶组(75.00%),研讨组并发症率(8.33%)低于硅胶组(33.33%),χ²=4.181,4547;P=0.041,0.033,P<0.05(具有统计学意义)。结论 耳软骨用于鼻综合整形手术治疗中可改善治疗情况,缩短手术、住院时间,提高满意度、减少并发症发生,值得推崇。     

Correlation between cytological characteristics of the nasal epithelium and the menstrual cycle

BACKGROUND: There has been considerable controversy concerning the effect of hormones on the nasal epithelium and, in particular, their association with the female reproductive state. OBJECTIVE: To investigate the relationship between cytological characteristics of the nasal epithelium and phase of the menstrual cycle.Design and Subjects Nasal smears were obtained from 15 women during the menstrual, follicular, and luteal phases, and the abundance of different cell types at each phase was compared with the abundance of equivalent cell types in vaginal smears during the follicular and luteal phases; the nasal smears were also compared with nasal smears from 20 postmenopausal women and 20 prepubertal girls. Epithelial cell counts were conducted by an observer blind to the origin of the samples. RESULTS: A significant correlation was found between the cytological characteristics of the nasal and vaginal smears and stage of the cycle, with cornified cells predominating during the follicular phase (median, 54%; range, 24%-65%) and rounded or spindle-shaped epithelial cells predominating during the luteal phase (median, 56%; range, 34%-73%). Cornified cells predominated in the nasal smears from the postmenopausal women (median, 71%; range, 60%-77%) and the prepubertal girls (median, 77%; range, 67%-81%) at all times tested. CONCLUSION: Cell turnover in the nasal epithelium may be related to hormonal state, and investigation of the mechanisms underlying such change should help in identifying possible functional consequences and in treating nasal symptoms associated with the female reproductive cycle.     

Cytologic aspects of the nasal respiratory epithelium throughout the menstrual cycle

A prospective study was performed to investigate the changes in nasal cytology that occur in healthy premenopausal women throughout the menstrual cycle. Eighty-eight women with an ovulatory menstrual cycle underwent nasal sampling with a cytobrush by direct vision of the middle and inferior nasal turbinates during the follicular, periovular, and luteal phases of the menstrual cycle, and the specimens were evaluated with the maturation index. Hematoxylin-eosin staining showed the cytologic aspects of the nasal respiratory epithelium and of vaginal smears according to the three different phases of the menstrual cycle. Along with the vaginal cells, the nasal respiratory epithelium is an ovarian steroid target.     

Extranasopharyngeal angiofibroma of the head and neck in women

Extranasopharengeal angiofibroma of the head and neck in women is very rare, and clinical characteristics do not confirm to that of nasopharyngeal angiofibroma. We present clinical characteristics, etiology, preoperative evaluation, and management of 3 unusual cases of angiofibroma, 1 case originating from larynx and the other 2 cases from nasal septum in women. Endolaryngeal endoscopic excision for laryngeal and local excision for septal angiofibromas were performed. The patients are free of disease. In the etiology of extranasopharyngeal angiofibroma, we suspect that ectopic tissue may become located further away than usual place and may have been the cause of the extranasopharyngeal location. Computed tomography scan, magnetic resonance imaging, and carotid angiogram are valuable in the diagnosis of extranasopharyngeal angiofibroma. Excision of the mass is the treatment of choice, and recurrence is rare.     

Experimental study of airflow in the main nasal cavity of the human using a nose model]

Airflow patterns of nasal cavities in a human nasal fossa model were examined in this study. Our 1:1 model of the whole nose (both nasal fossae were moulded) gives a good insight into all parts of the nasal cavities. Staining of flow paths visualised that the main stream of air flow passes through the inferior nasal duct in inspiration and expiration. All regions of the nasal fossa were reached by fluid movements and could be marked with staining solution. Under static conditions laminar flow without turbulent profiles was seen in all sections of the nasal cavities. This technique of detection of flow characteristics in the nasal cavities provides a good tool for further research on flow and deposition characteristics of aerosols.     

鼻内翻性乳头状瘤手术术式的选择与疗效

目的探讨鼻内镜术与传统术式相结合治疗鼻内翻性乳头状瘤的疗效,并对不同术式进行探讨。方法回顾性分析我科2002年1月～2009年1月有完整随访资料并接受鼻内镜手术治疗的54例鼻内翻性乳头状瘤患者的临床资料进行回顾性分析。其中采用单纯鼻内镜手术44例,采用鼻内镜联合改良柯-陆术式9例,采用鼻内镜联合鼻侧切开1例,并对所有患者术后进行随访。结果随访6个月至6年,3例术后复发,其余51例在随访期内均未见复发。结论鼻内镜下手术是一种安全有效的微创手术,可用于Ⅰ、Ⅲ级鼻内翻性乳头状瘤外科治疗,Ⅱ级病变可选择联合改良柯-陆术式,肿瘤已侵犯至鼻外的Ⅳ级病变需联合鼻侧切开径路去除病灶。彻底切除肿瘤、术后定期随访是治疗成功的关键。     

Hemangioma cavernous of the nasal cavity and the maxillary sinus--case report and review of the literature

Hemangiomas of the nasal cavity and especially paranasal sinuses are very rare. Authors reported a case of hemangioma cavernous of the nasal cavity and maxillary sinus in a 34-year-old women. Diagnostic procedures, therapeutic intervention were presented and literature reviewed.     

乌鲁木齐市成年人变应性鼻炎流行病学调查

目的调查乌鲁木齐市成人变应性鼻炎的发病率现状. 方法于2004年7月～9月,采用问卷调查形式,对有鼻部症状3339例成人采用鼻黏膜刮片查找肥大细胞和嗜酸性细胞,分析变应性鼻炎流行情况. 结果患AR病例数1003人,发病率为30.04%.50岁以下发病率随着年龄增长而上升(P<0.01);汉族发病率(33.36%),明显高于维吾尔族(19.19%),(P<0.01),男女发病率无明显差异(P>0.05). 结论变应性鼻炎的患病率有逐年增高的趋势.加强环境治理和个人防护以及积极有效的治疗,有助于控制变应性鼻炎患者的症状,减少并发症.     

Ultrastructural findings of the nasal mucosa of "ozaena" in atrophic rhinitis

Alterations in the nasal mucous layer of atrophic rhinitis "Ozaena" patients have been investigated. The vast majority (99%) of these patients were women. Morphological findings in healthy nasal mucosa demonstrated the different functional stages of the glandular tissue cells with the healthy epithelium. On the other hand, nasal mucosal material taken from the patients displayed prominent epithelial deterioration, decrease in and loss of cilia, increase in goblet cells with squamous epithelial metaplasia. A decrease in secretory granules and membrane deterioration in the apical region of the secretory cells was also clearly visible. It is possible to postulate that the ultrastructural changes seen in the secretory and storage cycles of glandular tissue of the nasal mucosa from patients seem to arise as a reaction to the superficial epithelial deterioration of the nasal mucosa together with the resulting deterioration of physiological conditions.     

Influence of nasal structure on the distribution of airflow in nasal cavity

STATEMENT OF PROBLEM: Numerical simulation of the nasal cavity is essential in order to understand the relationship between nasal structure and airflow characteristics. Since the structure of the nasal cavity varies significantly, the relationship between nasal structure and airflow characteristics will be investigated by numerical simulation of airflow in twenty-four nasal models in this paper. METHODS OF STUDY: Twenty-four three-dimensional models of the nasal cavity structure have been reconstructed on the basis of Computed Tomography medical images collected from twenty-four healthy volunteers. Modification of the turbinate has been applied to one of these models in order to simulate an operation. The results from this variant model have been compared with the original model. The numerical simulation for the airflow in the nasal cavity was performed by the finite element method. MAIN RESULTS: Pressure drop and the airflow distribution in nasal models are presented quantitatively in flow field. Main airflow will pass through the common nasal meatus. The nasal airway resistance in the region of nasal valve and nasal vestibule (flow limiting structure) accounts for 52.6%-78.3% of total nasal airway resistance. PRINCIPAL CONCLUSIONS: The numerical results show that differences in patients' nasal cavity structure may lead to different airflow distributions. Changes of nasal structure lead to variation of airflow in both sides of the nasal cavity as well as airflow redistribution in each side of the nasal cavity.