自体组织或组织代用品植入法纠正唇裂鼻翼畸形

目的：采用自体组织或组织代用品植入和可靠固定法纠正单侧唇裂因患侧梨状孔区上颌骨发育不良和鼻翼软骨移位塌陷而造成的鼻翼畸形。方法：自1996年以来采用自体肋骨、肋软骨、颅骨外板、硅橡胶或膨体聚四氟乙烯等材料植入患侧梨状孔下外侧、鼻翼基底区及鼻翼外侧软骨区，抬高患侧鼻翼基底、纠正塌陷之鼻翼软骨，以微型钛钉／板和缝合固定的方法纠正单侧唇裂鼻翼畸形26例。结果：术后创口愈合良好，无并发症发生。随访19例，3－18个月，表明植入物固定良好、无移位和明显吸收、排斥反应，效果良好。结论：组织植入法矫正单侧唇裂鼻翼畸形手术效果确切，以坚强内固定技术和缝合方法可减少植入物的移位、活动，有助于手术的成功。

Correction of secondary nasal alar deformities using onlay implantation in patients with unilateral cleft lip

Objective To attempt to achieve a more satisfactory results in correcting the unilateral cleft lip nasal deformities caused by deficiency of the maxilla and collapse of the alar cartilage, using onlay implantation and stable fixation for implants. Methods Since 1996, the authors had implanted rib cartilage (12 cases), rib bone and cartilage (4 cases), silicon rubber (8 cases), skull bone and ePTFE (one case each) in total 26 patients with moderate to severe nasal deformities of unilateral cleft lip to elevate the retro-position alar base in hypoplastic maxillar area and to augment the buckled lateral alar cartilage in effected side. All implants were fixed by absorbable sutures on alar cartilage, and titanic screw and/or plate on maxilla under alar base. Results All wounds recovered without any complication. During 3 to 18 months follow-up postoperatively in 19 cases, the nasal appearences were significantly improved. The implants still provided support for the depressed alar base and the collapsed alar cartilage without obvious displacement, absorption and rejection. Conclusion The onlay implantation and stable fixation using suture and rigid fixation of titanic screw and/or plate for implants is reasonably good in nasal deformity correction of unilateral cleft lip advocated. The definitive effects and well-maintenance of the implant dimension and position have been documented.