赵军利 焦兴友 王维群



鼻中隔软骨修复唇裂术后鼻畸形的临床研究

赵军利 焦兴友 王维群

【摘要】目的 探讨取自体鼻中隔软骨治疗唇裂术后鼻部畸形的疗效。方法 选择罹患唇裂术后鼻畸形患者28例，采用外科手术方法对移位的鼻部组织切开分离并将其恢复到理想位置，手术一并切除偏歪的鼻中隔软骨留做待用，矫治鼻中隔畸形，复位鼻小柱基底偏歪畸形，将手术切取的鼻中隔软骨修整外形，复位移植到鼻部塌陷区，完成唇裂术后鼻畸形的综合治疗。结果 自体鼻中隔移植治疗唇裂术后鼻畸形，非常满意人数24 例，占全部病例治疗满意率的85.7%；基本满意人数4例，占全部病例治疗满意率的14.3%；无不满意病例出现，且不易发生排斥、炎症及移植骨外露等情况。结论 自体鼻中隔软骨移植修复唇裂术后鼻畸形，避免增加术区，治疗效果良好。

【关键词】唇裂；鼻畸形；鼻中隔软骨

Objective To investigate the curative effect of autologous nasal septum cartilage in the treatment for cleft lip nasal deformity. Methods 28 cases with cleft lip nasal deformity were researched，they were treated with the surgical method to shift the nasal tissue dissection and restore it to the ideal location. Then cut the deviation of nasal septum cartilage by surgery and let it set aside. Then corrected the nasal septum malformation and reset partial distortion of the basement of nasal columella，then dressing contour the nasal septum cartilage and reset transplantation it to nose subsidence area. At last，the nasal deformity of cleft lip's comprehensive treatment were completed. Results After autogenous septal transplantation for the treatment of cleft lip nasal deformity，24 cases were very satisfied，accounting for 85.7%，4 cases were basically satisfied，accounting for 14.3%，there was no dissatisfied cases，and had no rejection，inflammation and graft bone exposure. Conclusion Autogenous septal cartilage transplantation has a good effect for the repair of cleft lip nasal deformity，it can avoid increasing the operation area and has a good treatment effect.

【Key words】 Cleft lip，Nasal deformity，Nasal septul cartilage

唇裂是口腔颌面部最常见的先天性畸形之一，特别是完全性唇裂常常同时伴有鼻部畸形的发生，目前成为口腔颌面外科唇裂治疗之后复诊要求治疗的较多见的疾病之一，唇裂术后鼻畸形的临床治疗方法，一直是临床具有争议的课题［1］。传统的完全性唇裂术后鼻畸形手术治疗以单纯恢复外形为主，手术几乎不涉及鼻中隔，将导致术后鼻部外形不理想或一段时间后鼻部畸形再次重现等缺点，移植组织修复鼻畸形效果尚佳，但因为术后排斥反应、增加手术区域等原因制约手术开展。……