鼻内镜下自体软骨鼻整形同期鼻中隔偏曲矫正治疗外伤性歪鼻畸形的临床分析

目的对鼻内镜下自体软骨（鼻中隔软骨、耳软骨和肋软骨）鼻整形同期行鼻中隔偏曲矫正治疗外伤性歪鼻畸形的临床分析。方法收集2017~2018年20 例陈旧外伤性歪鼻畸形患者的临床资料，所有患者均行全麻下鼻小柱倒“V”型切口暴露松解并切除偏曲的鼻中隔软骨及骨质，针对不同患者设计使用不同软骨（鼻中隔软骨、耳软骨和肋软骨）矫正鼻中隔骨性或软骨性支架，对鼻尖、鼻背及外鼻重新塑形。结果随访3~12个月，行鼻内镜下自体软骨鼻整形同期鼻中隔偏曲矫正术的患者鼻外形及通气均有明显改善，手术效果更好，无鼻腔粘连、鼻中隔血肿及穿孔。结论鼻内镜下自体软骨鼻整形同期鼻中隔偏曲矫正治疗外伤性歪鼻畸形同期解决了鼻部畸形和鼻通气功能，实现了美容和功能的统一，同时减少了手术治疗的次数和费用，可行性高。

Clinical analysis of endoscopic autologous cartilage rhinoplasty with simultaneous deviation correction of nasal septum for the treatment of posttraumatic nasal deformity

ObjectiveTo analyze the treatment of posttraumatic nasal deformity by endoscopic autologous cartilage (nasal septal cartilage, ear cartilage, costal cartilage) rhinoplasty with simultaneous deviation correction of nasal septum.MethodsFrom 2017 to 2018, 20 patients with old traumatic nasal deformities were admitted in our department. Under general anesthesia, the inverted V shaped incision was used to loosen and remove the deformed nasal septal cartilage and bone, and the septal scaffold was reestablished with individually designed autologous cartilage (nasal septal cartilage, ear cartilage or costal cartilage) combined with remodeling of nasal tip and nasal dorsum as well as the external nose.ResultsAll the patients had been followed up for 3 to 12 months postoperatively. Compared with simple closed reduction of nasal bone fracture or endoscopic correction of nasal septum deviation, the endoscopic autologous cartilage rhinoplasty with simultaneous deviation correction of nasal septum had better effect in improving nasal ventilation and nasal contour without more complications, which reduced the number and cost of operations.ConclusionWith advantages of unification of aesthetics and function by synchronous correction of nasal deformities and improvement of nasal ventilation, as well as reducing the number and cost of operations, endoscopic autologous cartilage rhinoplasty with simultaneous deviation correction of nasal septum is highly feasible for the treatment of posttraumatic nasal deformity.