隆鼻失败的再次手术治疗

目的：探讨隆鼻手术失败的原因及再手术时机和方法。方法：分析586例隆鼻术失败患前次手术失败原因，根据病因选择假体取出后再次手术时机，并通过改变隆鼻假体形态、性质及隧道剥离层次．对患进行再次隆鼻手术。结果：对于有感染并发症或鼻尖部组织菲薄，假体取出3个月后再次隆鼻手术。经过2个月～19a随访观察，有570例(97%)患取得满意手术效果。结论：对隆鼻失败原因及性质应区别对待．采取针对性治疗方法．可取得更满意疗效。     

女性鼻部二次整形修复的原因及影响因素分析

目的 探究鼻部二次整形修复手术的比例、原因和影响因素.方法 本研究纳入了进行鼻部二次修复咨询的患者379名,分析最终进行二次手术患者的数量、原因及影响因素.结果 考虑二次鼻整形术的原因中,最主要为对鼻尖的不满意,占87.6％;经过初次手术后,患者对于鼻上部、中部和其他部位的不满意数都在下降,但患者的鼻塞症状则在初次手术...     

开放式唇裂继发鼻畸形整形的护理

目的:总结单侧唇裂继发鼻畸形整形手术的护理方法。方法:对60例患者术前进行心理护理及术区准备,术中应用跨鼻小柱的鼻翼软骨下缘切口开放式鼻整形进行唇裂继发鼻畸形矫正,术后放置鼻孔支撑管1～2周,术后密切观察局部切口情况,进行切口护理,保持切口清洁,保持鼻支撑管固定稳定。结果:单纯进行鼻畸形矫正者14例,同时行唇畸形整形者46例,效果满意,其中有43例患者进行了6～24个月的随访,平均随访时间为11个月,鼻外形恢复良好。结论:应用开放式鼻整形技术进行唇裂继发鼻畸形矫正,可在直视下充分松解并显露鼻翼软骨,准确复位及缝合固定,术后效果稳定,切口无明显瘢痕。术后护理特别强调保持切口清洁及鼻支撑管放置稳妥。     

The Ideal Nose: Changing Concepts in Plastic Surgery

This paper discusses the strong motivation of patients requesting cosmetic surgery to their nose and outlines the plastic surgeon's approach to the assessment of these patients. The indications for nasal surgery are discussed, including psychological assessment before operation. Age considerations are reviewed. The reduction rhinoplasty operation is briefly outlined, emphasizing its adaptability to a great variety of nasal deformities. Criteria are given for planning a nose that will be harmonious with the face. The reduction in morbidity and improved results presently being obtained are stressed.     

自体肋软骨支架在鼻综合整形术中的应用探究

目的探讨鼻综合整形术中自体肋软骨支架的应用效果.方法回顾性分析本院收治的行鼻综合整形术治疗患者42例,采用自体肋软骨支架治疗,取右侧第7肋软骨自制呈人字形,构成鼻尖支架,联合肋软骨皮质和真皮组织塑造鼻尖形态.比较治疗前后患者的患侧鼻部外形变化情况,统计术后并发症发生情况,术后随访12个月统计患者治疗满意度和远期并发症,观察胸廓瘢痕恢复状态.结果术后患者的鼻孔横向直径、纵向直径鼻坎高度、鼻翼基底与面中线距离低于治疗前,鼻坎高度高于治疗前(P<0.05);术后恢复天数为(7.26±1.46)d,平均鼻尖突触高度为(0.55±0.12)cm,无1例患者出现假体突出、肿胀、渗血、感染等并发症;随访12个月,患者整形满意度评分为(8.61±1.05)分,无远期并发症发生,胸廓无明显瘢痕,恢复良好.结论鼻综合整形术中应用自体肋软骨支架美容效果良好,满意度较高,并发症风险较低,胸廓瘢痕恢复效果较好,值得推广.     

肋软骨移植修复单侧唇裂术后严重鼻畸形的临床探讨

[目的]探讨肋软骨移植修复单侧唇裂术后严重鼻畸形的疗效.[方法]切取一段肋软骨予以修整,植入鼻小柱内,重建鼻下端的鼻小柱支架结构,并在鼻底行“y”切口,“v”缝合或“z”交叉三角瓣成形术,切开皮肤皮下组织及肌层,并尽可能复位鼻唇肌肉,再造口轮匝肌环,以缩小鼻孔、修复鼻底嵴,并纠正鼻小柱歪斜.对上颌骨发育严重缺陷,鼻翼基底部凹陷明显者,可于鼻翼基底部及鼻底嵴处填充肋软骨片,以抬高鼻翼基底部及鼻底嵴.背部低平或偏斜者形成鼻背筋膜通道,利用取出的肋软骨塑形后同时进行隆鼻术.最后,鼻小柱行“v”“y”缝合以延长鼻小柱.鼻穹隆鼻缘皮肤通过鼻内转移来实现.[结果]鼻外形明显改善,患者满意度高.[结论]肋软骨移植修复单侧唇裂术后严重鼻畸形疗效满意,值得临床推广应用.     

Novel decellularized animal conchal cartilage graft for application in human patient

Restoration of the external ear and nose in human patients, in either congenital deformity or acquired defects, is a challenge in reconstructive surgery. Optimization of the currently available materials is necessary for rhinoplasty and microtia correction to avoid intraoperative manoeuvring and early rejection. The aim of this study was to develop cross‐linked decellularized caprine conchal cartilages as biocompatible, robust, and non‐toxic matrix template. The characterization of the decellularized tissue encompasses in vitro lymphoproliferation assay, cytotoxicity test, agar gel precipitation test, in vivo immunocompatibility study, histology, and determination of pro‐inflammatory cytokines in animal model. Decellularized cartilage was implanted in human volunteer at R. G. Kar Medical College and Hospital, Kolkata, India, and samples were assessed histologically by retrieving those after 4 months. The processed cartilages were implanted in rhinoplasty (nine) and microtia patients (six) keeping autogenous cartilage graft as control up to 18 months after surgery. Primary outcomes were viability and safety of the material, both in animal model and human pre‐application in actual site. Secondary outcomes included self‐assessed clinical findings on gross examination. This study is under the ethical approval no. RKC/14 dated January 27, 2012. The in vitro cellular reactivity was less in processed cartilage protein than control. Histology of retrieved tissues in animal model and human volunteer showed no adverse reactions. Production of IL‐2, IL‐6, and TNF‐α cytokines was lower at 4 weeks. The rhinoplasty and microtia operation in clinical patients utilizing the processed cartilage showed satisfactory recovery with improved facial look. These low cost, easily available, biocompatible, safe xenocartilage biomatrices of caprine conchal cartilage origin are very flexible in shape and size, enabling them as potential bioimplant for repair of nasal and auricular structure without any rejection or diverse biomedical applications.     

块状肋软骨移植物在隆鼻术中矫正鼻基底凹陷的临床效果

目的 通过利用块状肋软骨移植物、颗粒状肋软骨移植物对假体肋软骨隆鼻患者鼻基底凹陷矫正效果的临床观察,对比两种方法 的优劣势和远期效果.方法 选取2020年12月至2021年12月行假体肋软骨隆鼻术患者249例,按鼻基底移植物类型分为块状肋软骨移植物135例(54.22％)为观察组、颗粒肋软骨移植物组114例(45.78...     

The Effect of Lavender on Anxiety and Hemodynamic Status Before Septorhinoplasy and Rhinoplasty

PurposeAnxiety is one of the most common problems before surgery and surgery of the nose is one of the most concerning and challenging surgeries among the plastic surgeries. The aim of this research is to consider the impact of lavender fragrance on anxiety and hemodynamics status before the septorhinoplasty and rhinoplasty.DesignParallel randomized control trial.MethodsThis research was done by testing thirty-four candidates who were about to have the surgery in two groups of lavender (intervention) and control. The anxiety before and after surgery was examined by the Speilberger State Anxiety Inventory questionnaire and the hemodynamics status. For the analysis, the T- Test, Mann Whitney Test and the χ² Test were used.FindingsThe demographic features of the two groups were similar. Anxiety after the experiment was meaningful. The obvious anxiety in the lavender category was 25.8% and the controlled group had that decreased to 1.8%. The latent anxiety was reduced by 24.3% in the lavender group and increased by 8% in the controlled group. The systolic, diastolic and the heart rate after the intervention was less in the lavender group.ConclusionsDue to the ease of the inhalation of lavender and the lack of any report for the existence of any kind of side-effects for the prevention of anxiety during nose surgeries, it can be suggested that this approach can be effective for the controlling of the consistency of the patients’ hemodynamics.     

鼻整形植入材料的研究及进展

随着1955年日本的Nishihata首先报道了隆鼻手术,随后在全国整形医师的共同努力下,近年来已取得了空前的发展。随着生物材料在临床上的研究与应用极大地促进了隆鼻手术的进步,而伴随着复合材料、组织工程骨等技术的应用,隆鼻手术有了更大的提高。相信随着组织工程的进步,隆鼻手术在未来将能够不断发展壮大。     

Current concepts in the postoperative care of the rhinoplasty patient

This is a systematic review of the available literature and our own personal experience regarding the optimal management of the rhinoplasty patient. The routine utilization of nasal splinting, casting and perioperative antibiotics is supported. The management of a number of common early complications is also discussed. Meticulous technique based on sound structural principles and coupled with preoperative planning and attention to wound care will result in a favorable outcome in most individuals undergoing rhinoplasty.     

中国美貌汉族女性鼻部特征的测量

背景:目前,鼻外型的美学指标尚不统一建立中国美貌汉族女性鼻部特征的数据库,可以为美容整形治疗计划的制定提供理论依据。目的:对公众广泛接受的30例中国美貌汉族女性的鼻部特征进行了测量,观察中国美貌汉族女性鼻部的美学特征。方法:选取30例时尚杂志、电影、电视剧中美女明星的正、侧位脸型的照片,利用photoshop CS3.0软件对30例中国美貌汉族女性的16个外鼻指标进行测量分析。结果与结论:实验获得明星外鼻的长度、宽度、高度、深度和相关比例等多组美学、解剖学数据,包括:鼻宽-鼻长比为1∶1.15,鼻深-鼻宽比为1∶2,鼻宽-内眦间距比为1∶0.94,鼻宽-口角间距比为1∶1.43,且各比例相互间有一定相关性。结果证实,中国美貌女性鼻唇沟间距与鼻宽之比接近黄金比1∶0.618,外鼻相对面部不够突出。     

中国美貌汉族女性鼻部特征的测量

背景：目前,鼻外型的美学指标尚不统一建立中国美貌汉族女性鼻部特征的数据库,可以为美容整形治疗计划的制定提供理论依据.目的：对公众广泛接受的30例中国美貌汉族女性的鼻部特征进行了测量,观察中国美貌汉族女性鼻部的美学特征.方法：选取30例时尚杂志、电影、电视剧中美女明星的正、侧位脸型的照片,利用photoshop CS 3.0软件对30例中国美貌汉族女性的16个外鼻指标进行测量分析.结果与结论：实验获得明星外鼻的长度、宽度、高度、深度和相关比例等多组美学、解剖学数据,包括：鼻宽-鼻长比为1∶1.15,鼻深-鼻宽比为1∶2,鼻宽-内眦间距比为1∶0.94,鼻宽-口角间距比为1∶1.43,且各比例相互间有一定相关性.结果证实,中国美貌女性鼻唇沟间距与鼻宽之比接近黄金比1∶0.618,外鼻相对面部不够突出.     

Allergic Rhinitis

Patients with allergic rhinitis have a chronically stuffy nose. Usually their sense of smell is dulled, and their nose discharges clear mucus. To differentiate other conditions from allergic rhinitis and to establish a diagnosis, the physician must take a careful history to ferret out possible precipitating factors and meticulously examine the nose, using phenylephrine hydrochloride or similar drugs to shrink mucous membranes.     

多层螺旋CT在鼻骨骨折中的诊断价值

目的：探讨多层螺旋CT（Multi-slice spiral CT,MSCT）在鼻骨骨折的临床诊断价值。材料与方法：60例鼻外伤病人均行MSCT容积扫描后行多种后处理图象重建并与X线片进行分析比较。结果：X线片60例患者中诊断鼻骨骨折者28例,8例可疑骨折,其余未见明显骨折。60例患者行MSCT容积扫描后行多种后处理图象重建后显示鼻骨骨折56例,其中单侧鼻骨骨折33例,双侧鼻骨骨折23例,伴上颌骨额突骨折40例,伴泪骨骨折8例,伴鼻中隔骨折15例,骨折伴鼻额缝分离13例,鼻骨间缝分离移位18例,并发眶壁骨折12例,伴鼻颌缝分离移位38例,上颌窦壁骨折5例。4例MSCT检查未见异常。结论：MSCT容积扫描检查鼻骨骨折明显优于常规CT和X线平片。MSCT检查能准确地显示鼻骨及周围各骨结构,对鼻骨骨折的类型、部位及其伴发改变显示全面、准确,是当前诊断鼻骨骨折的一种可靠、安全、有效的检查方法,为临床选择治疗方案和法医学鉴定提供可靠依据。     

自体耳软骨联合硅胶隆鼻术的并发症护理分析

目的探讨自体耳软骨联合硅胶隆鼻术的并发症防治性护理措施。方法选取2017年6月~2019年4月期间在本院行自体耳软骨联合硅胶隆鼻术治疗的50例患者作为研究对象。患者均接受自体耳软骨联合硅胶隆鼻术(局部麻醉),根据患者围术期要求进行预防性临床护理,追踪调查患者术后并发症情况,并评估患者对鼻部外形的满意度。结果 18例患者对外形非常满意(36.00%),29例患者对外形基本满意(58.00%),3例患者对外形不满意(6.00%),满意率为94.00%(47/50)。50例患者中出现3例术后感染患者,3例出现术后肿胀淤血情况,1例患者术后存在鼻倾斜,1例患者术后,出现局部组织异物反应、排斥反应,故取出硅胶假体。结论自体耳软骨联合硅胶隆鼻术围术期采用针对性、预防性临床护理干预,可有效防控并发症风险,促进局部顺利恢复,并提升患者对于鼻部外形满意度。     

Rhinoplasty: clinical categorization as a practical preoperative guide

As progressively more individuals desire rhinoplasty, facial surgeons are experiencing a wider spectrum of potential patients. The young woman in her late teens and 20s once made up the majority of the rhinoplasty case load. Now, the patients desiring aesthetic and reconstructive nasal surgery represent all stages of life. We have divided the patient population into five categories based principally on the special requirements of inherent chronologic differences. This typing system guides rhinoplastic surgeons in dealing with a variety of age groups of both sexes. These categories are useful in defining differences in technique and as an adjunct to preoperative evaluation.     

隆鼻术失败类型及相关因素分析

目的 总结分析隆鼻术失败的原因及类型,探讨不同修复方法 .方法 回顾性分析2015年9月-2020年10月天津市职业病防治院耳鼻喉科及天津医科大学第二医院整形与医疗美容科于门诊行隆鼻术者423例的临床资料.总结隆鼻术失败的类型,记录隆鼻术失败后二次手术修复方案及效果.结果 423例隆鼻术者术后发生并发症84例,发生率为...     

人工鼻在人工气道患者湿化气道中应用的效果观察

目的观察人工鼻在气管切开患者气道湿化中应用效果。方法将神经外科ICU气管切开患者99例,根据气管切开日期随机分为3组,采用人工鼻气道湿化患者32例为人工鼻湿化组,采用微量泵持续气道湿化患者34例为微量泵入湿化组,采用定时间断气道湿化患者33例为定时湿化组,观察患者痰液分泌量、吸痰次数、气道湿化程度及应急反应。结果人工鼻湿化组在减少患者日均吸痰量、日均吸痰次数、湿化不足、湿化过度及高气道反应明显优于微量泵入湿化组和定时湿化组,分别经方差分析两两比较、行乘列卡方检验两两比较,均有显著性差异,P<0.001或P<0.05;增加气道阻力,3组均无明显差异,P>0.05。结论人工鼻在减少痰液分泌量、吸痰次数及保持良好气道湿化效果明显优于微量泵入湿化和定时湿化的方法。