[摘要]目的：评价结合鼻中隔软骨移植修复成人唇裂继发鼻畸形的效果。方法：选取2022年10月-2024年9月于西安交通大学口腔医院就诊的17例成人唇裂继发鼻畸形患者为研究对象，进行唇鼻部肌肉重建，并采用鼻部开放切口，取鼻中隔软骨移植于鼻小柱处，悬吊鼻翼软骨，从而矫正鼻小柱短偏，改善鼻翼及鼻基底塌陷。术后7 d开始佩戴鼻模。采用三维图像进行测量，评价术前、术后7 d、术后1个月鼻部形态。结果：术后7 d鼻底宽度、鼻孔高度、鼻翼角度及鼻小柱偏斜角度指标均优于术前，差异有统计学意义（P＜0.05）。术后1个月鼻部对称性稍有复发，但仍优于术前。结论：唇鼻部肌肉重建结合鼻中隔软骨移植修复成人单侧唇裂继发鼻畸形可使鼻部对称性得到改善。

[关键词]单侧唇裂；继发鼻畸形；鼻中隔软骨；鼻整形；移植

[中图分类号]R765.9" " [文献标志码]A" " [文章编号]1008-6455（2025）06-0016-04

Short-term Study on Septal Cartilage Graft in Secondary Unilateral Cleft Lip Rhinoplasty

BI Sisi1，2，3， LI Jinfeng1，2，3， TAO Yongwei1，2，3， GAO Ming1，2，3， REN Zhanping1，2，3

（ 1.Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research， 2.Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases， 3.Department of Cleft Lip and Palate Surgery， College of Stomatology， Xi'an Jiaotong University， Xi'an 710004， Shaanxi， China ）

Abstract： Objective" To evaluate the effect of septal cartilage graft in secondary cleft lip rhinoplasty of adult cases. Methods" 17 adult patients with secondary cleft lip nasal deformity in College of Stomatology， Xi'an Jiaotong University since October 2022 to September 2024 were selected as the object of the study.All the patients were performed with secondary rhinoplasty. We reconstructed the nasal-labial muscle， applied the septal cartilage to reconstruct the nasal column， corrected the collapsed alar cartilage， and reconstructed the nasal base， thereby raising the nasal tip， correcting the nasal column， alar cartilage and nasal base. The nasal splint was worn 7 days after surgery. Three-dimensional images and photos were used for measurement. The nasal morphology before surgery as well as 1 week and 1 month after surgery were analyzed. Results" There were significant differences on symmetry ratios including nostril height， nasal base width and columella deviation compared between before and after operation（P＜0.05）. Despite a few recurrence of nasal deformity 1 month after surgery， the nasal morphology were still better than pre-operation. Conclusion" The nasal symmetry can be improved when combined with nasal-labial muscle reconstruction and septal cartilage graft in secondary cleft lip rhinoplasty.

Key words： unilateral cleft lip; secondary nasal deformity; septal cartilage; rhinoplasty; graft

唇裂术后继发鼻畸形通常是由多种因素共同作用引起的。唇鼻部肌肉、软骨和颌骨等组织的发育异常、组织量不足等原因，以及既往手术遗留的瘢痕都可能导致继发畸形。与双侧唇裂相比，单侧唇裂继发鼻畸形对称性较差，修复手术更为困难和复杂。唇裂继发鼻畸形的临床特征表现多样[1]，因此修复术式并不是单一固定的，本研究针对鼻小柱短偏、患侧鼻翼及鼻底塌陷的部分病例，采用了结合鼻中隔软骨移植的鼻畸形整复，取得了较好的效果，现对这些病例进行回顾及评价分析。

1" 材料和方法

1.1 病例选择：选取2022年10月-2024年9月于西安交通大学口腔医院就诊的17例成人单侧唇裂继发鼻畸形患者为研究对象，其中男7例，女10例。……