自体耳软骨联合自体真皮组织在假体隆鼻修复术中的应用(1)
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[摘要]目的：探讨应用自体耳软骨与自体真皮组织以增加鼻尖部与鼻背部组织高度，并联合假体材料进行隆鼻修复术。方法：取耳甲腔软骨雕刻成形，固定在假体鼻尖部；取颞部头侧真皮，覆盖在假体背部表面，将此复合假体置入原有鼻背隧道内。结果：本组患者25例，随访6个月～1年，无假体变形及皮肤坏死，患者对假体外形及透光度等方面的改善效果满意。结论：应用自体耳软骨增加鼻尖组织高度，自体真皮组织增加鼻背组织高度，在隆鼻修复术中能有效解决原有隆鼻术造成的鼻尖及鼻背组织变薄发亮、假体轮廓不自然等不良并发症。
[关键词]自体耳软骨；自体真皮组织；假体；隆鼻
[中图分类号]R622 [文献标识码]A [文章编号]1008-6455(2012)05-0732-03
Application of auricular cartilage and cephalicdermis in conjunction with implant in rhinoplasty again
SHI An-ping1, LUO Sheng-kang2, ZHOU Shao-long2,WU Qiong3,QIU Jun4
(1.Department of Plastic＆Cosmetic Surgery,Foshan Hongxing Clinic,Foshan,528000, Guangdong,China;2.Department of Plastic ＆ Cosmetic Surgery,The Second Guangdong Provincial People's Hospital,Guangzhou,510000,Guangdong,China;3.Department of Plastic ＆ Cosmetic Surgery, Guangzhou Zhujiang Hospital; 4. Department of Plastic＆Cosmetic Surgery,Ruikang Hospital of Guangxi Traditional Chinese Medical University ,Nanning,530000, Guangxi,China )
Abstract: Objective To evaluate the superiority of rhinoplasty again by using auricular cartilage and cephalic dermis inconjuntion with implant. Methods suitablesize of auricular cartilages carved to some shape were covered nasal tip of implant and suitablesize of cephalisc dermis were covered the surface of implant, then inserted underfascia of bridge of the nose to carry out augmentation rhinoplasty. Resules 25 patients were followed from 6 months to one year, they were satisfied with esthetic and table shape of bridge of the nose and nasal tip, without deformation of implant and skin necrosis. Conclusions The augmentation rhinoplasty again by using auricular cartilage and cephalic dermis transplantation inconjunction with implant can obtain satisfactory clinincal result.
Key words:auricular cartilage;augmentation rhinoplasty;cephalic dermis; implant
2009年8月～2011年3月，笔者应用自体耳软骨与自体真皮组织联合固体硅胶或膨体聚四氟乙烯(PTFE)假体材料，对25例隆鼻术后出现皮肤变薄透亮、假体轮廓不自然的患者进行再隆鼻修复手术，效果良好，现报道如下。
1 临床资料
本组共25例患者。全部为女性；年龄19～45岁，平均31岁，其中鼻背皮肤变薄透亮10例；鼻尖皮肤变薄透亮6例；鼻背及鼻尖皮肤同时变薄透亮9例。术后最长的8年，最短的2年。
2 方法
2.1 假体的选择：11例选择韩式生科(HANS)三段式硅胶假体，14例选择膨体聚四氟乙烯假体，均为L型假体。
2.2 自体耳软骨的切取：由耳甲腔背后部切口入路，切取直径约0.5cm带软骨膜的软骨块，放入盛有庆大霉素、生理盐水混合液的注射器中备用。
2.3 自体真皮组织的切取：由颞部发际线平行向上5cm ......
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