Repairing the twisted nose

Correction of the deviated nose presents a challenge to even the experienced rhinoplastic surgeon. This article describes the etiology, analysis, and surgical treatment for the severely twisted nose. The applied anatomy of the deviated nose is discussed in detail. Finally, a graduated approach to surgical management is described.     

Management of the twisted nose

This presentation discusses the development, pathophysiology, and method of management of the twisted nose. The surgical logistics of staging, open and closed approach, anesthetic method, and reconstructive planning are considered in detail.     

Early repair for infants with cleft lip and nose

OBJECTIVE: To study the results 10 years after early surgical cleft lip and nose repair. PATIENTS AND METHODS: We present the outcome of 123 early cleft lip repairs whose condition was managed in a multidisciplinary team according to a strict protocol. We give the observation results of operations of a single surgeon's neonatal surgery over a 10-year period in term of aesthetic assessments and dental arch relationships. One hundred and twenty-three patients were operated on during the first 4 weeks of life; a subgroup of 40 child had been operated on at a week or less of age. RESULTS: The results show good aesthetic assessments and dental relationships, with facial growth appropriate for the age. CONCLUSIONS: We are currently encouraging early cleft lip and nose repair in the full-term baby as the good method of management of newborns with cleft.     

前臂皮瓣Ⅰ期修复面及咽部肿瘤术后软组织缺损

目的 :探讨前臂皮瓣在耳鼻咽喉 头颈外科头颈部恶性肿瘤手术中的应用。方法 :对 6例咽喉部肿瘤切除后软组织缺损的病例 ,通常采用前臂皮瓣修复 ,即将皮瓣的桡动脉、头静脉与甲状腺上动脉和面静脉分别端端显微吻合 ,Ⅰ期修复组织缺损。结果 :修复成功 4例 ,失败 2例。结论 :前臂皮瓣具有血管表浅 ,行程稳定 ,口径粗 ,血管长 ,前臂皮肤薄、软、皮下脂肪少 ,具可塑性 ,可折叠等优点。经临床应用证实 ,前臂皮瓣修复是一种灵活多用 ,技术完善的头面、咽部及口底缺损修复的手段     

外鼻恶性肿瘤的精准切除及缺损修复

目的:探讨精准切除外鼻恶性肿瘤以及准确评估、合理修复组织缺损的方法。方法:回顾性分析解放军联勤保障部队第九八〇医院2010年1月至2020年6月期间收治的48例外鼻恶性肿瘤患者,其中男性28例,女性20例,年龄36~86岁。肿瘤病理类型包括基底细胞癌29例,鳞状细胞癌11例,外毛根鞘癌6例,腺样囊性癌1例,非霍奇金淋巴...     

外鼻基底细胞癌切除及缺损一期修复

目的 探讨外鼻基底细胞癌的手术及术后一期修复的方法.方法 2002年1月至2010年6月,手术治疗外鼻基底细胞癌62例,采用Mohs手术多个方向切缘的病理以确保彻底切除后,其缺损包括一侧鼻翼外侧部分软组织缺损、鼻翼游离缘缺损、鼻翼完全缺损、鼻尖软组织缺损、鼻翼鼻尖缺损、鼻背缺损,依据外鼻缺损及肿瘤侵犯程度的不同,采用不同的皮瓣,以鼻翼沟、鼻唇沟为中心,应用推进皮瓣、鼻唇沟软组织蒂岛状皮瓣、鼻唇沟返折皮瓣、额部轴型皮瓣、游离耳廓复合软组织瓣等方式一期修复.结果 62例患者中2例皮瓣术后完全坏死,1例皮瓣大部坏死,只有上缘小部分成活,2例出现边缘部分坏死,2例出现周边部分表皮脱落.其余55例皮瓣成活,所有成活皮瓣外形满意,1例有明显鼻塞,其余鼻腔通气功能良好.随访半年至8年未见肿瘤复发.结论 外鼻基底细胞癌采用Mohs手术多个方向切缘的病理以确保切除彻底,术后依据缺损部位及程度应用各种皮瓣,特别是邻近带蒂皮瓣,一期修复外鼻缺损,成活率高,外形整复效果良好.     

Architectural deficiencies of the nose: treatment of the saddle nose and short nose deformities

The saddle nose and short nose deformities are challenging surgical problems characterized by significant architectural deficiencies of the nasal framework. These defects produce cosmetic and functional nasal problems. Reconstructive techniques and augmentation materials are reviewed. Case examples illustrate the authors currently preferred techniques.     

应用多孔高密度聚乙烯为支架的一期全耳廓再造

目的 探讨多孔高密度聚乙烯(Medpor)生物植入体的组织相容性。寻找外形理想,手术简便的外耳再造新方法。方法 以Medpor为耳廓支架,掀起耳后皮瓣及耳后筋膜瓣,将支架植入两者之间,并按合适的解剖位置固定于耳后乳突区骨膜上。耳后及筋膜组织瓣创面植皮。结果 自1998年3月～2000年12月,应用Medpor为支架一期再造耳廓8例,2例发生支架部分外露,经修补后未再发生外露现象,其余病例形态满意。结论 Medpor生物植入体组织相容性良好。以它做为支架再造耳廓,可免除患者胸部切取肋软骨造成的痛苦和畸形,且形态良好。但该植入体价格贵,质地硬是其不足之处。     

鼻中隔一期重建硬腭部分缺损的研究

目的探讨利用鼻中隔对硬腭部分缺损进行术后修补的可行性。方法回顾性分析11例上颌窦癌患者的临床资料,上颌骨截除术后均采用一期鼻中隔修补硬腭部分缺损。结果 11例患者中8例肿瘤切除后硬腭重建一期愈合,2例出现小裂隙,1例发生鼻中隔坏死。结论上颌骨切除术后,可利用鼻中隔一期修补硬腭缺损。     

先天性外中耳畸形的Ⅰ期手术整复

目的 :探讨 期整复术治疗先天性外耳、中耳畸形和外耳道闭锁并存的患者的疗效。方法 :耳廓成形术 :取自体肋软骨作支架 ,患耳颞部超薄皮瓣及皮下组织瓣包裹软骨支架形成再造耳廓。鼓室成形术 :根据鼓室畸形情况作 型或大鼓室 型成形术 ;外耳道再造 :用全厚皮片移植。结果 :术后随访 4～ 6年 ,全部病例外耳道宽畅 ,成形鼓膜完整。语言频率听阈降低均达到应用水平 ;再造耳 11耳成活 ,8耳外形满意。结论 : 期整复术是治疗外耳、中耳畸形和外耳道闭锁并存的有效方法。     

Hamartomas of the nose

Three cases of hamartomas of the nose, very rare conditions in otolaryngology are reported. According to the Willis (1953) classification two of these cases, belonged to the angiomatous, and the third one to the lipomatous, group of hamartomas.