亚明宏 黄绍丽 何永靖 汤婷 张颖佳 郭群

[摘要]目的：探讨以肋软骨皮质作为鼻小柱支撑移植物在鼻尖整形中的应用效果。方法：2017年6月-2019年6月，应用肋软骨皮质为鼻小柱支撑移植物修复鼻尖形态126例，切取右侧第6或7肋部分软骨，再取肋软骨皮质雕刻皮质片插入鼻中隔前后角两侧，以作鼻小柱支撑移植物。根据患者鼻部情况，利用其余的肋软骨皮质或髓质塑造鼻尖形态，膨体或硅胶假体雕刻固定抬高鼻背行鼻综合整形术。结果：本组126例患者均取得良好效果。随访3～12个月，鼻尖外形保持良好，鼻尖表现点明显，鼻头、鼻小柱手感柔软，效果满意。结论：以肋软骨皮质为鼻小柱支撑移植是鼻尖整形中一项良好的手术技术。

[关键词]肋软骨皮质;鼻小柱支撑移植物;鼻尖整形;鼻综合整形术

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）06-0050-03

Application of Graft Supported by Costal Cartilage Cortex as Columella in Tip Rhinoplasty

YA Ming-hong1，HUANG Shao-li2，HE Yong-jing3，TANG Ting3，ZHANG Ying-jia3，GUO Qun3

（1.Kunming Beauty Cube Medical Cosmetology Hospital，Kunming 650101，Yunnan，China;2.Department of Plastic Surgery，Yunnan Dermatology Hospital，Kunming 650101，Yunnan，China;3.Department of Plastic Surgery，the Second Affiliated Hospital of Kunming Medical University，Kunming 650101，Yunnan，China）

Abstract： Objective  To investigate the effect of using costal cartilage cortex as support graft the nasal columella in tip rhinoplasty. Methods  From June 2017 to June 2019， 126 cases of nasal tip reconstruction patients were treated with costal cartilaginous cortex supported graft. The 6th or 7th costal cartilage on the right side was cut off and the costal cartilage cortex was carved to support the columella. According to the nasal conditions of the patients， the nasal tip was shaped by the other costal cartilage cortex or medulla， and augmentation of nasal dorsum with expanded or silicone prosthesis for comprehensive rhinoplasty. Results  All 126 patients achieved good results. The patients were followed up for 3-12 months， and the nasal tip shape was kept good， the nasal tip showed obvious signs， the nasal tip and nasal columella were soft， and the results were satisfactory. Conclusion  It is a good surgical technique to use costal cartilage cortex as nasal columella support for tip rhinoplasty.

Key words： costal cartilage cortex; support graft of the nasal columella; tip rhinoplasty; comprehensive rhinoplasty

鼻整形手術需要对鼻尖部进行改善，而鼻小柱支撑移植物的选择及应用对手术的效果起着关键作用。Anderson[1]提出的鼻尖“三角架”理论是指导鼻尖整形的有力工具。东方人由于鼻翼软骨发育不良，尤其是内侧脚的发育更差。要依据三脚架理论来调整鼻尖，就必须加强或者重建三脚架的结构，鼻小柱支撑移植是通过将有支撑力的软骨插入鼻翼软骨内侧脚间来加强中间脚架的有力手段。所以鼻小柱支撑在鼻尖整形中起着相当重要的作用。本研究以肋软骨皮质为鼻小柱支撑移植物，探讨其在鼻尖整形中的应用效果。

1  资料和方法