致密多晶羟基磷灰石微粒人工骨经鼻小柱切口隆鼻术

本文分析了５２９例鞍鼻患者采用致密多晶羟基磷灰石微粒人工骨经鼻小柱切口隆鼻术的临床效果;获得较满意的临床效果。ＨＡ是一种比较理想的隆鼻材料但有待改进;鼻小柱切口无明显瘢痕形成适合于采用颗粒状ＨＡ材料的隆鼻术。     

致密多晶羟基磷灰石微粒人工骨整复鞍鼻

用致密多晶羟基磷灰石微粒人工骨整复鞍鼻６０例，并对手术方法以及并发症的预防和处理进行讨论。方法：采用鼻小柱正中切口，于鼻背筋膜下腔隙注入ＨＡ，手法塑形。效果：对鼻形满意者５６例，不理想者４例。作者认为ＨＡ作为隆鼻的填充物对人体安全有效，且无毒性和炎症反应。该手术进路证明，技术操作容易，损伤极小，并发症少，是目前较为理想的隆鼻材料。     

致密多晶羟基磷灰石微粒人工骨整复鞍鼻

用致密多晶羟基磷灰石微粒人工骨整复鞍鼻６０例，并对手术方法以及并发症的预防和处理进行讨论。方法：采用鼻小柱正中切口，于鼻背筋膜下腔隙注入ＨＡ，手法塑形，效果：对鼻形满意者５６例，不理想者４例，作者认为ＨＡ作为隆鼻的填充物对人体安全有效，且无毒性和炎症反应。该手术进路证明，技术操作容易，损伤极小，并发症少，是目前较为理想的隆鼻材料。     

羟基磷灰石微粒人工骨隆鼻术50例八年随访

为探讨羟基磷灰石（简称ＨＡ）微粒人工骨作为隆鼻术移植材料的远期效果，对ＨＡ人工骨植入隆鼻的５０例受术者进行了８年随访观察。通过受术者对手术效果的自我评价，临床医师对术后有关指标的客观检查，同时通过Ｘ线片对ＨＡ置入体的位置，形态及与鼻骨的关系进行了观察分析，随访观察的结果表明，ＨＡ微粒人工骨隆鼻术手术效果良好，ＨＡ作为隆鼻术的充填材料远期疗效稳定，是一种理想的具有生物活性的新型隆鼻材料。     

羟基磷灰石微粒人工骨隆鼻术50例八年随访

为探讨羟基磷灰石（简称ＨＡ）微粒人工骨作为隆鼻术移植材料的远期效果，对ＨＡ人工骨植入隆鼻的５０例受术者进行８年随访观察。通过受术者对手术效果的自我评价，临床医师对术后有关指标的客观检查，同时通过Ｘ线片对ＨＡ置入体的位置、形态及与鼻骨的关系进行观察分析。随访观察的结果表明，ＨＡ微粒人工骨隆鼻术手术效果良好。ＨＡ作为隆鼻术的充填材料远期疗效稳定，是一种理想的具有生物活性的新型隆鼻材料。     

羟基磷灰石微粒人工骨隆鼻术50例八年随访

为探讨羟基磷灰石(简称 HA)微粒人工骨作为隆鼻术移植材料的远期效果,对 HA 人工骨植入隆鼻的50例受术者进行8年随访观察。通过受术者对手术效果的自我评价,临床医师对术后有关指标的客观检查,同时通过 X 线片对 HA 置入体的位置、形态及与鼻骨的关系进行观察分析。随访观察的结果表明,HA 微粒人工骨隆鼻术手术效果良好。HA 作为隆鼻术的充填材料远期疗效稳定,是一种理想的具有生物活性的新型隆鼻材料。     

羟基磷灰石微粒人工骨注入隆鼻的效果

目的探讨利用羟基磷灰石微粒人工骨（partical hydroxylaptite artificial bone, HA）修复鞍鼻的可行性及规范的手术操作;以及隆鼻失误后如何适当取出。方法用眼科剪或骨膜剥离器紧贴鼻骨,由鼻小柱旁切口进入,于鼻背筋膜深层分离隧道,在隧道内置入羟基磷灰石微粒,手法按摩塑形,缝合切口。结果18年HA注入隆鼻15000例,获随访6482例,优良率占94％,差和失败率占6％。结论对于鞍鼻和鼻外形基本正常而苛求尽善尽美者,利用HA注入隆鼻法,可获得满意、长期、稳定的效果,不失为一种可供选用的隆鼻方法。     

Relationship between the protrusion of the nasal tip and the dorsum in Rhinoplasty

The author discuses the relationship of the nasal tip and its protrusion to the physical contours of the dorsum. This relationship can be positive or negative. He emphasizes the necessity of correcting the tip before any correction of the dorsum, believing that correction of the alar cartilages is the key that determines the amount of hump resection or of lowering of the nasal dorsum, demonstrating his concepts with appropriate case illustrations. The author's technique (1974) of forward projection of the lower nasal base with a transverse silicone implant for patients with a negative tip-dorsum relationship is described.     

眶距增宽症鼻成形术

目的 总结59例眶距增宽症鼻成形术的临床经验,以期探讨眶距增宽症鼻畸形整复的方法。方法 鼻部整复术大多采用眶间鼻背部正中V形切口,部分采用矢状切口,面裂鼻尖缺失者,鼻背皮肤行V-Y成形术向下推进延长鼻梁,严重者全鼻下部向下推进,鼻背部骨膜下移修复,鼻腔衬里缺损,眶间鼻部鞭骨缩窄鼻宽度,鼻支架发育不全可植入自体骨填高鼻梁,鼻小柱短小者植入物修成L形,移植骨用螺钉或钢丝结扎固定。结果 本组病例鼻梁宽度平均缩窄2cm,鼻深增高0.6cm,鼻长度延长0.8cm,16例雨季期行鼻部瘢痕修整术,4例由于鼻梁低平二期再行植骨术,无植骨感染坏死、外露排出并发症,结论 眶距增宽症都有外鼻畸形,矫正眶距时可同期行鼻成形术,V-Y成形术可有效地延长鼻梁,鼻背部骨膜向下推移可修复鼻腔衬里缺损,采用肋骨填高鼻梁较为理想,部分病例需行二期手术。     

鼻尖肥大的整形修复

目的　探讨治疗鼻尖肥大的手术方法 ,以获得美观鼻外形。方法　本组 2 8例患者 ,均采用“飞鸟形”切口 ,根据鼻尖形态 ,修剪鼻尖部过多的软组织 ;显露鼻翼软骨外侧脚和穹窿后 ,剪除外侧脚至穹窿处侧鼻软骨侧部分软骨 ,保留鼻翼缘处 0 .2cm宽鼻翼软骨外侧脚 ,缝合穹窿以重塑鼻尖外形。矫正鼻部其他畸形 :10例鼻尖低平者 ,行硅胶假体隆鼻 ;9例鼻翼肥厚者 ,修薄鼻翼缘 ;3例鼻翼基底过宽者 ,经口内入路缝合缩窄鼻翼 ;1例鼻底过宽者 ,凿开上颌骨鼻突 ,挤压缩窄塑形。结果　自 1995年以来 ,用上述方法整复 2 8例患者 ,经 3个月至 2年随访 ,除 3例鼻尖肥大矫正不足外 ,其余 2 5例效果稳定 ,无继发畸形发生。结论　鼻尖肥大需综合整复 ,方能获得良好的效果。     

黄种人鼻整形的研究进展

黄种人的鼻整形是在鼻整形领域中的一个扩展性的研究命题。虽然各种鼻整形技术的主要原则同样适用于黄种人．但由于种族因素和解剖学差异,黄种人的鼻整形有其独有的特点。在近些年的研究中,黄种人的鼻部整形呈现一些值得注意的进展。本文就黄种人群鼻整形中鼻背部整形、植入材料、鼻尖成形及隆鼻后并发症处理方面等的最新进展进行综述。     

注射法超微粒人工骨隆鼻术

目的　为部分鼻梁高度仅需增加少量或只对鼻子某个部位填充的患者塑造一个完美的鼻形。方法　采用特制的注射器配 14号长穿刺针 ,贴骨面刺入 ,边退边缓缓注入超微粒人工骨 ,至外形满意。结果　 68例患者经半年以上的随访 ,外形满意者 5 6例 ,占 82 .3 % ;外形较原来有较大改善者 8例 ,占 11.7% ;外形不满意者 4例 ,占 6%。结论　采用注射超微粒人工骨隆鼻术可达到满意的临床效果 ,对于那些需精雕细凿、修修补补的隆鼻者 ,不失为一种较好的手术方法     

The lost muscles of the nose

This is a review of the muscular anatomy of the nose. Areas of inconsistency in the main anatomy texts are highlighted and concentrate particularly on the omission of three identifiable muscles from modern textbooks. Two topographical areas of the nose in need of further anatomical development are identified. In a sample of 121 subjects from the general population, 40% were found to be incapable of flaring the nostrils voluntarily or subconsciously in conjunction with energetic inspiration with the mouth closed. The authors recommend systematic clinical assessment of the nasal musculature be incorporated in the pre- and postoperative examination of the rhinoplasty patient. The division of the nose into five sections for assessment is proposed and the muscles contributing to each area are defined together with their individual surgical relevance.This paper was presented at the Frank Cort Prize Meeting, Birmingham, United Kingdom, 12 March 1994     

Transfixion incision as an initial technique in nasal tip deprojection

BACKGROUND:

The overprojected nasal tip presents a significant challenge to the surgeon performing rhinoplasty. Full transfixion incision as a means of dealing with this deformity has been studied only in combination with other surgical methods.

OBJECTIVES:

To determine whether transfixion incision alone would result in significant nasal tip deprojection, and if skin thickness had an effect on the extent of deprojection the procedure yielded.

METHOD:

Seventy-two consecutive patients with an aesthetic goal of nasal tip deprojection were enrolled. The sole surgical means of deprojection used was transfixion incision. Subjects were categorized as thin-, medium- or thick-skinned based on the surgeon’s analysis. These groups were compared in terms of their postprocedural nasal tip deprojection.

RESULTS:

Using transfixion incision as the sole means of correcting this deformity resulted in a mean nasal tip deprojection of 1.6 mm (ranging from 0 mm to 3 mm). Patients in the thin skin group had a mean deprojection of 2.12 mm. This was significantly greater than for both the medium- and thick-skinned groups. There was no significant difference between the medium- and thick-skinned groups.

CONCLUSIONS:

Surgeons may use skin thickness when planning interventions for correcting nasal tip overprojection. When used alone, transfixion incision resulted in tip deprojection comparable with that achieved when combined with other methods, particularly for thin-skinned patients. Surgeons can thus use a graduated approach in which transfixion incision, the least destructive method, is used before proceeding with other interventions.     

鼻中隔软骨充填驼峰鼻整复术

目的 介绍用鼻中隔软骨充填整复驼峰鼻的方法。方法 为30例驼峰鼻患者在黏膜下切取鼻中隔软骨，将其分成2～3部分，缝合在一起，移植于驼峰样突起的上下两端鼻背相对凹陷处，使鼻背恢复平直外观。结果 30例患者长期随访，效果均较满意。结论 鼻中隔软骨充填整复驼峰鼻是一种新的有效方法。