臀沟旁真皮片移植在隆鼻术鼻尖成形中的应用观察
|
摘要
目的观察臀沟旁真皮片移植联合硅胶假体植入在隆鼻术鼻尖成形中的应用效果。方法对28例鼻梁低平、鼻尖圆钝及5例既往行硅胶假体隆鼻而术后出现鼻尖皮肤菲薄的患者进行手术治疗,通过将臀沟旁真皮片固定于雕刻好的假体鼻尖处,形成臀沟旁真皮片-鼻假体联合体,整体植入鼻背筋膜下进行隆鼻,以增加鼻尖皮肤厚度,形成鼻尖良好形态。结果所有患者随访6～12个月,效果良好,鼻尖形态自然、柔和、美观,鼻尖部位没有出现明显吸收导致的皮肤变薄,未出现鼻尖皮肤破溃、假体外露现象。结论利用臀沟旁真皮片移植联合硅胶假体隆鼻可增加鼻尖组织厚度,塑形鼻尖,并有效预防隆鼻术后假体直接作用于鼻尖皮肤而引起的鼻尖皮肤变薄、假体下滑、假体外露等并发症的发生,具有供区隐蔽、取材方便、鼻尖成形后外形及质感自然的优点。
Objective To observe the effect of natal cleft dermis slice transplantation combined with silicone prosthesis implantation applied to nasal tip rhinoplasty. Methods Twenty-eight patients who had lower nasal dorsum and bulbous nose tip, and 5 patients who reported nose tip skin thinning due to prior augmentation rhinoplasty with silicone prosthesis were involved in the surgery. A combination of natal cleft dermis slice and nasal prosthesis, developed by suturing the natal cleft dermis slice to the tip of prefabricated nasal prosthesis, served as one implantable unit under nasal dorsal fascia for augmentation rhinoplasty to thicken nasal tip skin and achieve perfect appearance of nosal tip. Results All patients were followed up for 6-12 months with a favorable efficacy, presenting a natural, harmonious and elegant appearance of nose tip, no nasal tip skin thinning due to obvious absorption in nasal tip was noted, neither skin ulceration in nasal tip nor prosthesis exsertion was observed. Conclusion The application of natal cleft dermis slice transplantation combined with silicone prosthesis to augmentation rhinoplasty can increase the thickness of nasal tip, remodel nasal tip, effectively prevent complications such as nasal tip skin thinning, prosthesis downslide and exsertion caused by the direct action of prosthesis on nasal tip skin after augmentation rhinoplasty, and has the advantages of concealed donor area, convenient material collection, and natural appearance and texture after nasal tip rhinoplasty.
Objective To observe the effect of natal cleft dermis slice transplantation combined with silicone prosthesis implantation applied to nasal tip rhinoplasty. Methods Twenty-eight patients who had lower nasal dorsum and bulbous nose tip, and 5 patients who reported nose tip skin thinning due to prior augmentation rhinoplasty with silicone prosthesis were involved in the surgery. A combination of natal cleft dermis slice and nasal prosthesis, developed by suturing the natal cleft dermis slice to the tip of prefabricated nasal prosthesis, served as one implantable unit under nasal dorsal fascia for augmentation rhinoplasty to thicken nasal tip skin and achieve perfect appearance of nosal tip. Results All patients were followed up for 6-12 months with a favorable efficacy, presenting a natural, harmonious and elegant appearance of nose tip, no nasal tip skin thinning due to obvious absorption in nasal tip was noted, neither skin ulceration in nasal tip nor prosthesis exsertion was observed. Conclusion The application of natal cleft dermis slice transplantation combined with silicone prosthesis to augmentation rhinoplasty can increase the thickness of nasal tip, remodel nasal tip, effectively prevent complications such as nasal tip skin thinning, prosthesis downslide and exsertion caused by the direct action of prosthesis on nasal tip skin after augmentation rhinoplasty, and has the advantages of concealed donor area, convenient material collection, and natural appearance and texture after nasal tip rhinoplasty.
引文
[1] 李东,安阳.中国人鼻整形几个问题的探讨[J].中国美容整形外科杂志,2015,26(6):321-323.
[2] 黄和平,王斌,黄琳玲,等.硅胶假体隆鼻术并发症的分析及防治[J].中国美容医学,2013,22(20):2004-2006.
[3] 李高峰,刘志刚.人工鼻假体与耳甲软骨联合植入隆鼻术[J].中国美容医学,2013,22(3):392-393.
[4] 熊俊文,徐文捷.鼻中隔软骨联合耳软骨在东方人鼻尖中的应用及疗效[J].中国医疗美容,2016,6(9):20-22.
[5] 黄文,倪云志,杨建,等.自体筋膜脂肪组织片移植在鼻尖成形中的应用[J].中国美容医学,2009,18(4):468-470.
[6] 齐向东,张斌,赵卉,等.利用耳后筋膜及鼻中隔软骨的二次鼻整形术[J].中国美容整形外科杂志,2013,24(12):711-714.
[7] 韩晓云,刘育凤.颞浅筋膜游离移植在面部整形的应用[J].齐齐哈尔医学院学报,2011,32(10):1634.
[8] 陈晓华,何晋龙,于攀,等.鼻中隔软骨联合自体真皮组织在鼻综合整形术中的应用[J].中国美容整形外科杂志,2014,25(7):418-421.
[9] 杨盼,张鹏,李信峰,等.自体鼻中隔软骨联合自体真皮移植隆鼻术:32例临床报告[J].中国美容整形外科杂志,2015,26(12):712-714.
[10] 张万仁,孙亚臣.皮肤厚度调查[J].解剖学杂志,1992,15(4):294-297.
[11] 李艳宁,李智贤,卢月华,等.高频超声对正常成人皮肤厚度测量及声像研究[J].中国医学影像技术,2008,24(10):1622-1624.
[2] 黄和平,王斌,黄琳玲,等.硅胶假体隆鼻术并发症的分析及防治[J].中国美容医学,2013,22(20):2004-2006.
[3] 李高峰,刘志刚.人工鼻假体与耳甲软骨联合植入隆鼻术[J].中国美容医学,2013,22(3):392-393.
[4] 熊俊文,徐文捷.鼻中隔软骨联合耳软骨在东方人鼻尖中的应用及疗效[J].中国医疗美容,2016,6(9):20-22.
[5] 黄文,倪云志,杨建,等.自体筋膜脂肪组织片移植在鼻尖成形中的应用[J].中国美容医学,2009,18(4):468-470.
[6] 齐向东,张斌,赵卉,等.利用耳后筋膜及鼻中隔软骨的二次鼻整形术[J].中国美容整形外科杂志,2013,24(12):711-714.
[7] 韩晓云,刘育凤.颞浅筋膜游离移植在面部整形的应用[J].齐齐哈尔医学院学报,2011,32(10):1634.
[8] 陈晓华,何晋龙,于攀,等.鼻中隔软骨联合自体真皮组织在鼻综合整形术中的应用[J].中国美容整形外科杂志,2014,25(7):418-421.
[9] 杨盼,张鹏,李信峰,等.自体鼻中隔软骨联合自体真皮移植隆鼻术:32例临床报告[J].中国美容整形外科杂志,2015,26(12):712-714.
[10] 张万仁,孙亚臣.皮肤厚度调查[J].解剖学杂志,1992,15(4):294-297.
[11] 李艳宁,李智贤,卢月华,等.高频超声对正常成人皮肤厚度测量及声像研究[J].中国医学影像技术,2008,24(10):1622-1624.