改良倒“L”法内眦赘皮矫正术联合切开法重睑术的临床效果

目的 探究肋软骨皮质搭建支架在鼻整形术中的应用效果。方法 选取2021年5月-2022年8月于 本院行鼻整形术的60例患者为研究对象,采用随机数字表法分为对照组和观察组,各30例。对照组给予硅 胶材料搭建支架,观察组给予肋软骨皮质搭建支架,比较两组愈合情况、整形满意度、鼻部三维指标（鼻 尖突度、鼻长、左右鼻尖顶点间距）、鼻部美学指标（鼻唇角、鼻面角、鼻额角）、鼻通气功能（鼻腔容 积差值、鼻腔最小横截面积差值、鼻腔呼气吸气阻力差）、生活质量（术后心理健康、社会功能）及并 发症发生情况。结果 观察组愈合优良率为100.00%,高于对照组的86.67%（P＜0.05）;观察组对鼻尖、鼻 形、鼻孔的整形满意度评分均高于对照组（P＜0.05）;观察组鼻尖突度、鼻长、左右鼻尖顶点间距均优于 对照组（P＜0.05）;观察组鼻唇角、鼻面角、鼻额角均优于对照组（P＜0.05）;观察组术后心理健康、社 会功能评分均高于对照组（P＜0.05）;观察组并发症总发生率低于对照组（P＜0.05）。结论 肋软骨皮质 搭建支架在鼻整形术中的临床应用效果优于硅胶材料搭建支架,可促进切口愈合,改善鼻部形态,有利于 提高患者的整形满意度和生活质量,且术后并发症发生几率较小,安全性较高,值得临床应用。     

自体肋软骨联合硅胶假体鼻整形效果探讨

目的:探讨自体肋软骨联合硅胶假体在鼻整形中的应用效果。方法:回顾性分析2015年5月-2017年5月笔者医院接受鼻整形的105例就医者临床资料,通过治疗方式不同分为观察组55例和对照组50例,对照组使用硅胶假体隆鼻,观察组使用自体肋软骨联合硅胶假体隆鼻,比较两组手术情况、鼻部塑形效果、二次手术率及并发症发生情况。结果:两组手术成功率、愈合时间比较,差异无统计学意义(P>0.05);观察组手术时间明显长于对照组,差异有统计学意义(P<0.05)。和术后3个月时比较,观察组术后12个月时鼻根高、鼻面角、鼻尖角、鼻额角差异无统计学意义(P>0.05);对照组术后12个月时鼻根高、鼻面角、鼻尖角均明显降低(P<0.05),且术后12个月时,观察组鼻根高、鼻面角、鼻尖角均明显高于对照组(P<0.05)。观察组二次手术率为3.64%(2/55)明显低于对照组的16.00%(8/50),差异有统计学意义(χ^2=4.646,P=0.031)。观察组术后并发症总发生率为14.55%明显低于对照组的32.00%,差异有统计学意义(P<0.05)。结论:和单用硅胶假体相比,自体肋软骨联合硅胶假体用于鼻整形中效果更加显著,具有鼻部塑形效果满意、二次手术率低、并发症少等特点,临床应用价值高。     

自体肋软骨移植构建鼻尖软骨复合体在鼻整形中的应用效果

目的 探究自体肋软骨移植构建鼻尖软骨复合体在鼻整形中的应用效果。方法 选取2021年1月-2022年6月我院收治的150例鼻整形患者作为研究对象,随机分为对照组及研究组,每组75例。对照组单纯利用膨体聚四氟乙烯假体,研究组进行自体肋软骨移植构建鼻尖软骨复合体,比较两组手术前后的鼻尖突出度、创面愈合时间、愈合程度、不良反应发生情况以及整形满意度。结果 研究组创面愈合时间短于对照组,差异有统计学意义（P＜0.05）;研究组术后鼻尖突出度高于对照组,差异有统计学意义（P＜0.05）;研究组不良反应发生率低于对照组,愈合程度优于对照组,差异有统计学意义（P＜0.05）;研究组整形满意度评分高于对照组,差异有统计学意义（P＜0.05）。结论 自体肋软骨移植构建鼻尖软骨复合体在鼻整形中的应用效果较好,能够呈现出较为自然的鼻形状态,患者认可度更高。     

Use of Autologous Costal Cartilage Combined with Expanded Polytetrafluoroethylene in Asian Rhinoplasty

BackgroundThe corresponding author's experience and recent methods employed in autologous costal cartilage grafts combined with expanded polytetrafluoroethylene (ePTFE) in Asian rhinoplasty were presented in this study.ObjectivesThe purpose of this study was to assess the outcomes of rhinoplasty performed on patients using autogenous costal cartilage grafts combined with an ePTFE implant.MethodsSeventy-five rhinoplasty cases with autologous costal cartilage grafts and an ePTFE implant were retrospectively reviewed. Graft types, complications associated with the graft itself or graft harvesting, surgical outcomes, and patient satisfaction were assessed.ResultsThe mean follow-up time post-operation was 13.5 months. A total of 42/75 patients underwent revision surgeries. Graft-related complications were found in 8% of cases, including two warped graft and four infection cases. Three individuals with infections had mild graft resorption. One patient with an infection removed the implant. Graft exposure, mobility, and substantial resorption were not recorded. A total of two cases underwent revision procedures for infection and perforation, respectively. Chest incision lengths for graft harvesting averaged 2.1 cm. No pneumothorax or significant donor-site pain was found. Donor-site scars were negligible, although two cases had hypertrophic chest scars. In general, functional and esthetic outcomes were mostly satisfactory among the assessed patients.ConclusionsRhinoplasty using autologous rib cartilage provides adequate support and sufficient cartilage amounts for correcting nasal contouring. Meanwhile, ePTFE alone for nasal dorsum augmentation safely achieves satisfactory outcomes. Rib cartilage rhinoplasty performed by an experienced surgeon yields excellent, long-lasting results with minimal risk; however, the potential for infection should be considered following revision surgery.     

肋软骨与耳软骨联合硅胶假体隆鼻效果比较

目的:比较耳软骨联合硅胶假体与肋软骨联合硅胶假体隆鼻的应用效果。方法:收集2017年7月1日-2018年12月31日笔者医院收治的鼻整形患者160例,随机按1:1比例分为对照组(n=80)与观察组(n=80),对照组采取耳软骨联合硅胶假体隆鼻,观察组采取肋软骨联合硅胶假体隆鼻,比较两组患者手术时间与愈合时间,术后随访6个月比较两组鼻整形效果满意度,鼻部外观相关指标改善情况以及并发症发生的变化情况。结果:两组手术时间与愈合时间比较差异无统计学意义(P>0.05)。术后随访6个月,两组鼻唇角、鼻额角、鼻尖长度、鼻尖突出率以及面部突出度明显改善,差异有统计学意义(P<0.05);观察组鼻唇角、鼻尖突出率以及面部突出度改善幅度更佳,差异具有统计学意义(P<0.05)。观察组并发症发生率为3.75%低于对照组的15.00%,总满意度为93.75%明显高于对照组的77.50%,差异有统计学意义(P<0.05)。结论:肋软骨联合硅胶假体隆鼻相比于耳软骨联合硅胶假体在鼻部整形美学角度改善方面具有更好的效果,术后并发症少,值得临床推广。     

自体肋软骨移植构建鼻尖软骨复合体在鼻整形手术中的美学效果

目的 探究鼻整形手术中鼻尖软骨复合体采用自体肋软骨移植构建的美学效果。方法 选取2022年 7月-2023年7月于我院进行鼻整形的患者169例,按照随机数字表法分为A、B两组,A组84例,B组85例。 A组构建鼻尖软骨复合体时使用膨体聚四氟乙烯材料,B组使用自体肋软骨材料,比较两组外观满意度、鼻 唇角、鼻面角、额鼻角及鼻背高度测量值。结果 B组外观满意度为87.06%,高于A组的57.14%（P＜0.05）;两 组治疗后鼻唇角、鼻面角、额鼻角均高于治疗前,且B组高于A组（P ＜0.05）;两组治疗后鼻背高度均高 于治疗前（P ＜0.05）,但两组治疗后鼻背高度比较,差异无统计学意义（P ＞0.05）。结论 鼻整形手术中 鼻尖软骨复合体采用自体肋软骨移植构建可提升外观满意度,增加鼻唇角、鼻面角、额鼻角及鼻背高度。     

单侧唇裂继发鼻畸形自体肋软骨移植整复的围手术处理

唇裂患者一般均伴有不同程度的鼻部畸形,其修复方法很多,但对于严重鼻部畸形,仅用简单的方法难以达到满意的效果。唇裂鼻畸形特征多样,主要和软骨的异位和发育不良有关。2006年7月～2008年5月,我科采用自体肋软骨移植修复30例先天性唇裂整复术后继发严重鼻畸形患者,取得较好的效果,现将同手术期处理方法总结如下。     

舒铂生物材料鼻支架与自体肋软骨鼻支架在隆鼻术中的应用效果

比较舒铂生物材料鼻支架与自体肋软骨鼻支架在隆鼻术中的应用效果。方法 抽取中国医科 大学空军特色医学中心2021年4月-2023年5月收治的100例隆鼻术患者为研究对象，采用随机数字表法分 为对照组和观察组，各50例，对照组予以自体肋软骨鼻支架隆鼻术治疗，观察组予以舒铂生物材料鼻 支架隆鼻术治疗，比较两组并发症发生情况、切口愈合情况及鼻部美学指标水平。结果 观察组并发 症发生率为2.00%，低于对照组的8.00%，差异无统计学意义（P ＞0.05）；观察组切口Ⅰ级愈合率为 88.00%，略低于对照组的92.00%，但差异无统计学意义（P ＞0.05）；两组术后6个月鼻面角、鼻尖角 均高于术前，且观察组高于对照组（P ＜0.05）。结论 采用舒铂生物材料鼻支架、自体肋软骨鼻支架进 行隆鼻术术后后并发症发生风险及切口愈合情况相近，而舒铂生物材料鼻支架隆鼻术鼻部美学效果更 佳，值得临床应用。     

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

分析块状肋软骨移植物在隆鼻术中对鼻基底凹陷患者的矫正效果。方法 选择2021年 5月-2023年5月于我院行隆鼻术的100例鼻基底凹陷患者为研究对象，采用随机数字表法分为对照组和 观察组，各50例。对照组行颗粒状肋软骨矫正，观察组行块状肋软骨矫正，比较两组鼻部美学角度测 量值、并发症发生情况及满意度。结果 观察组小柱上唇角、小柱小叶角、鼻面角及鼻额角均高于对照 组，差异有统计学意义（P ＜0.05）；观察组并发症发生率为4.00%，低于对照组的20.00%，差异有统计 学意义（P ＜0.05）；观察组满意度为100.00%，高于对照组的80.00%，差异有统计学意义（P ＜0.05）。结 论 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良好，能够改善患者的凹陷症状，提高鼻部 美学效果，且术后并发症发生几率较低，患者满意度较高。     

三维立体耳支架成形在二期全耳廓再造中的应用体会

目的 临床分析32例三维立体耳支架成形在二期全耳廓再造中的应用体会.方法 从2001年～2005年对32例小耳畸形患者应用自体肋软骨二期全耳再造法进行耳廓再造共33个,手术Ⅰ期为耳解剖结构三维轮廓再造,Ⅱ期为颅耳角再造.结果 本组32例,30例手术效果满意,2例外耳轮软骨尖端弹开外露,行外露软骨再固定,局部皮肤转瓣缝合,痊愈.随访3个月～4年,再造耳廓具有个性化的三维立体轮廓.结论 应用自体肋软骨耳支架成形进行的耳解剖结构轮廓再造取得了满意的效果,再造耳廓具有个性化的三维立体轮廓,拥有良好的颅耳角,能承受日常生活压力.     

Augmentation Rhinoplasty with a Combination of Triple Cartilage Grafts for Secondary Rhinoplasty in a Middle-Aged Population

Because of physiologic changes with advancing age as well as previously traumatized and then healed tissues, secondary rhinoplasty for a middle-aged patient is a challenging procedure. Depending on both factors, changes in the midvault can cause a functional airway disorder, and the nose also may need a complete correction for cosmetic purposes. To achieve aesthetic and functional outcomes, augmentation rhinoplasty using a combination of triple cartilage grafts, namely, spreader, columellar, and dorsal onlays, was performed for 12 patients. Sufficient nasal airways with satisfactory appearance were achieved for 11 of 12 patients. Only one patient had improved but still insufficient nasal function with a good aesthetic result. Augmentation rhinoplasty using a combination of triple cartilage grafts for middle-aged patients could be considered an effective procedure for improving the patient’s nasal airway and appearance.     

Allogenous Cartilage Graft Versus Autogenous Cartilage Graft in Augmentation Rhinoplasty: A Decade of Clinical Experience

Cartilage grafts have great value in augmentation rhinoplasty. For most surgeons, an autogenous cartilage graft is the first choice in rhinoplasty because of its resistance to infection and resorption. On the other hand, an allogenous cartilage graft might be preferred over an autogenous graft to avoid additional morbidity and lengthened operating time. Allogenous cartilage grafts not only have the advantage of averting donor site morbidity but also are resistant to infection, resembling autogenous cartilage grafts. The authors present their experience with 41 patients who underwent augmentation rhinoplasty using 22 autogenous and 19 allogenous cartilage grafts between June 1994 and August 2004. For evaluation of adequate augmentation rates, photographic analyses were performed on preoperative, early postoperative, and late postoperative photographs from all the patients. To assess patient satisfaction, the Facial Appearance Sorting Test (FAST) was applied preoperatively and late postoperatively in both groups. These results were compared, and it was concluded that in terms of resorption, there was no difference in the early and late postoperative follow-up data between allogenous and autogenous cartilage grafts. Evaluation of the preoperative and early postoperative photographic outcomes showed statistically significant differences with respect to adequate augmentation rates between the two groups. The FAST scores showed statistically significant differences between preoperative and late postoperative outcomes. There were no infections in the two groups of patients. Commentary to DOI: .     

异体松质骨复合自体红骨髓移植材料的制备及临床应用

目的探讨异体松质骨复合自体红骨髓移植。移植材料的制备方法及其临床应用效果。方法无菌条件下获取的异体松质骨，经降低抗原性处理和环氧乙烷(EO)二次灭菌。与自体红骨髓相复合制成复合移植材料。临床用于治疗粉碎性骨折、骨不连和骨缺损56例。结果所有病例无排斥反应和感染等并发症发生，获得8个月以上随访的28例均骨性愈合。结论异体松质骨复合自体红骨髓移植安全、有效，是修复骨折和骨缺损的较好材料。     

不切断胸骨和肋软骨的微创倒T形内固定术矫治儿童漏斗胸

目的总结不切断胸骨和肋软骨的倒T形内固定术治疗儿童漏斗胸的疗效。方法2005年5月至2007年5月采用不切断胸骨和肋软骨的倒T形内固定术矫治2~4岁漏斗胸患儿30例,其中不对称漏斗胸4例,合并肋缘外翻畸形12例。结果平均手术时间50(40~75)min,术中出血3~10 ml,术后4~9 d痊愈出院。30例胸骨均得到满意矫正,术后胸骨抬高平均3.1(1.5~5.0)cm,胸脊距平均6.2(4.0~9.7)cm。未发现并发症。随访15(3~24)个月,漏斗胸均获矫正,12例肋缘外翻畸形得到了满意矫正,仅1例患儿遗留胸壁不对称及扁平胸。结论该术式治疗2~4岁儿童漏斗胸具有手术时间短、创伤小、恢复快、手术瘢痕小、并发症少、效果满意、住院时间短和住院费用低的特点,简单易行,值得推广。