鼻尖部神经鞘瘤1例附文献复习

目的探讨鼻部神经鞘瘤的性质、临床表现、病理特点及手术治疗。方法报道1例鼻尖部神经鞘瘤患者的临床资料,并结合文献复习。结果经手术切除鼻尖部肿块,病理确诊为鼻尖部神经鞘瘤。随访1年无复发。结论发生于鼻尖部的神经鞘瘤十分罕见,治疗以手术为主,术后效果良好。     

自体软骨移植在隆鼻术中的应用

目的：探讨自体软骨移植填充鼻尖在隆鼻术中的应用。方法：根据受术者鼻尖的形态及软组织厚度,本组119例患者中有57例采用自体耳软骨移植联合“L”形人工假体行鼻成形术,33例采用鼻翼软骨移植联合“L”形人工假体行鼻成形术,29例采用鼻中隔软骨移植联合柳叶形人工假体行鼻成形术。结果：所有患者术后鼻部美学效果均明显改善,其中64例随访3～12个月,鼻部形态良好,医患双方满意。结论：根据受术者鼻尖不同情况选择不同的自体软骨移植填充鼻尖联合假体植入行鼻成形术,组织相容性好,有效重塑鼻尖外形,鼻部整体形态符合美学效果。     

自体鼻中隔软骨联合膨体聚四氟乙烯与自体耳软骨移植在鼻尖整形中的对照研究

目的 评价自体鼻中隔软骨联合膨体聚四氟乙烯移植与自体耳软骨移植在鼻尖整形中的临床效果.方法 对照观察自体鼻中隔软骨联合膨体聚四氟乙烯移植(A组:70例)与自体耳软骨移植(B组:48例)在鼻尖整形中的疗效、手术操作时间及术中术后并发症.以SPSS 12.0软件进行t检验或x2检验.结果A组手术操作平均((x)±s)时间短于B组,差异有统计学意义(t=13.258,P=0.000).A组鼻尖宽度在6～8 mm的67例(95.7％),B组46例(95.8％),差异无统计学意义(x2=0.001,P=0.996);2组患者鼻尖表现点、后旋角、鼻背与鼻小柱夹角、鼻尖高度差异均无统计学意义(x2值分别为0.001、0.069、0.149、0.073,P值均＞0.05).结论 自体鼻中隔软骨联合膨体聚四氟乙烯与自体耳软骨移植术临床效果相近.     

应用自体鼻中隔骨、软骨鼻成形术

我科于 1 990～ 1 998年 ,应用自体鼻中隔骨、软骨行鼻成形术 1 6例 ,疗效满意。报告如下。1　资料与方法1 .1 　临床资料1 6例中 ,男 1 0例 ,女 6例 ;年龄 1 9～ 52岁 ,平均 3 0 .6岁。均有鼻外伤史 ,病程 3个月～ 3年。主诉鼻塞者 1 3例 ,经常头痛 8例 ,反复鼻出血 3例。大部分为鞍鼻畸形 ,鼻背塌陷 4例 ;2例鼻尖低下。检查 :均有鼻中隔偏曲 ;其中 1例一侧鼻腔粘连。1 .2 　手术方法患者取半卧位。局麻后根据不同情况取一侧鼻前庭皮肤与鼻粘膜交界处稍后方切口 ,或取鼻小柱基底的双侧鼻孔缘内联合切口。按鼻中隔矫正术充分暴露鼻中隔软骨…     

自体鼻中隔软骨联合耳廓软骨的鼻中隔延伸物移植术在鼻尖整形中的应用

目的:探讨运用鼻中隔软骨联合耳廓软骨构建鼻中隔延伸物复合体重置鼻尖位置和重塑鼻尖形态的可行性。方法:2018年9月至2019年10月,以中国医学科学院整形外科医院17例低鼻患者为研究对象,17例患者中男2例,女15例;年龄19~39岁,平均27岁。17例患者均为初次鼻整形病例。术中在全身麻醉下行鼻整形术。切取鼻中隔软骨...     

鼻内镜下改良鼻中隔矫正术

目的 探讨鼻内镜下改良鼻中隔矫正术的方法及效果。方法 对56例鼻中隔偏曲患者行鼻内镜下改良鼻中隔矫正术。采用鼻内镜下鼻中隔左侧前端切口,分离左侧黏软骨骨膜,分离软骨与骨性部相连处并切除细条状软骨,切除偏曲骨质。软骨部偏曲者则接受划痕切开或选择性小块切除软骨。结果 随访6个月,56例鼻中隔偏曲患者临床症状消失,未出现明显并发症。结论 鼻内镜下改良鼻中隔矫正术疗效好,损伤小,鼻中隔矫正满意,可在临床推广使用。     

亚洲人鼻尖部血液供应

随着外鼻成形术的不断开展 ,鼻小柱切口可能会损伤鼻小柱动脉而引起鼻尖部变形或皮肤坏死 ,因此鼻尖部血液供应特点的研究倍受重视。以往的研究对象多为白种人 ,亚洲人的鼻外形有着自己的特点 ,为了研究亚洲人的鼻尖部血液供应 ,对 51具亚洲人尸体的10 2侧鼻尖部血管进行了解剖 :动脉灌注后 ,肉眼观察血管形态、分支来源及走行分布 ,同时对皮下血管的位置和来源进行了观察。结果发现 :鼻尖部的最主要营养血管是鼻外侧动脉 (始自于面动脉 ) ,占 78% ( 80 /10 2 ) ,另有 2 2 %由鼻背动脉供应 (始自于眼动脉 ) ,来自于上唇动脉的鼻小柱分支血管…     

鼻中隔次全重建术:初步报告

鼻中隔软骨位于鼻腔中线自上而下与侧方软骨连接,是鼻的重要支持结构。鼻中隔成形术和鼻中隔矫正术应特别注意保护鼻中隔的“L”形结构。这种结构一直延伸到鼻尖(图1),以保证鼻背一定形状。如缺失可引起鞍鼻或鼻背塌陷,其前角位于“L”形软骨的膝部,通过鼻内韧带支持鼻下外侧软骨,如缺失可引起鼻尖缺如;“L”形软骨片尾部支持的丧失可能导致鼻尖和鼻     

鼻内镜下鼻中隔成形术切口的选择

随着内镜鼻外科的不断发展 ,鼻内镜下鼻中隔手术已得到了耳鼻咽喉科医师的普遍认可 ,因此鼻内镜下鼻中隔成形术〔1〕切口的选择愈来愈引起人们的重视。笔者根据鼻中隔偏曲的部位、形态和范围 ,选择恰当的手术切口 ,疗效满意。现总结如下。1　资料和方法1 .1 　 临床资料岁岁 ,平均 2 9岁。Kiillian手术切口 2 5例 ,鼻前庭皮肤“L”形切口 1 6例 ,鼻中隔骨软骨交界处黏膜纵形切口 8例 ,鼻中隔棘或嵴尖部横形切口 1 1例 ,鼻中隔棘或嵴前纵形黏膜切口 6例。 6 6例中有2 8例伴有单组或多组鼻窦炎 (其中 1 0例伴有鼻息肉 ) ,43例伴有下鼻甲肥大…     

鼻翼回缩术——一种调整鼻尖过突的方法

鼻尖过突相对来说并不很常见,但对整形学却具有挑战性。该作者选择20例由于鼻翼软骨过度发育而导致的鼻尖过突患者,术前利用计算机影像学处理系统对其行鼻面夹角及Goode比例测量,相同的测量于术后6个月重复进行;此外,对鼻外观也要进行评估,尤其要强调鼻背高度、鼻长度、鼻翼夹角、鼻小柱外观大小以及鼻尖突出的程度和弧度。首先行鼻中隔软骨     

Surgery of the nasal tip

Summary  The nasal tip is considered most difficult area in entire rhinoplasty. The shape of the nasal tip is altered primarily by changes of lower lateral cartilages. or by badly performed surgery. For the assessment of the tip, its shape must be considered in relationship to the rest of the nose and face. Various types of tip deformities may be encountered. Tip may be overprojected, underprojected, bulbous or retruded columella may be deformed or there may be alar flaring. Tip surgery should be properly planned and accomplished meticulously to achieve pleasing results. Delivery flap technique provides excellent exposure and can deal with most of the tip deformities successfully.     

Surgery of the nasal tip

Ten operative procedures for surgery of the nasal tip are described and illustrated with case photographs. A working understanding of the various tip techniques described should allow the rhinoplastic surgeon to achieve consistently good results.     

Cartilage grafts for the nasal tip

Control over nasal tip projection is essential in rhinoplasty. Nasal projection is defined as the length of the perpendicular drawn from the anterior facial plane to the tip-defining point. Between 1989 and 1991, 300 patients underwent an external rhinoplasty. In 94 (31%) an autologous graft for the nasal tip was used. The aesthetic result was pleasing to the vast majority of the patients. Nasal tip rigidity resolved in all patients within one year post-operatively. One patient needed revision surgery, because of graft resorption. The nasal lobule shield-type graft, made of autologous cartilage, is one of the most important methods to maintain projection. The graft may also control length, (counter)rotation of the nose and refinement of the tip. The external approach facilitates in-situ suturing and sculpting of the graft.     

Evaluation of nasal tip surgery.

Nasal tip surgery has been evaluated with respect to correction of the lower lateral cartilages. Indications, techniques, results, and complications related to three generic approaches to the lower lateral cartilages are described. In 673 consecutive rhinoplasties the commonest type of nasal tip surgery was excisional, utilizing either a marginal or cartilage splitting technique. These techniques were utilized: 1. to accomplish debulking, and 2. to accomplish the installation of facets. The excisional technique found its greatest utility in primary rhinoplasties. The version technique, utilizing a change of direction of the thrust of the lower lateral cartilages was utilized in a variety of situations, particularly for the correction of moderately congenitally hypoplastic tip cartilages. It also found great utility in surgery of the Negro or cleft palate nose, increasing tip projection, correcting unacceptable bifidity, and in revision rhinoplasty. Augmentation rhinoplasty, utilizing conchal cartilage as an elastic strut was particularly useful for severe hypoplastic cartilage deficits, the Negro nose, columellar retraction, and alar rim deficits. The overall complication rate of lower lateral rhinoplasty was 17.4 percent. The rate of unacceptable complications related to lower lateral rhinoplasty was 2.7 percent.