改良式多層次自體耳郭軟骨於鼻背增高的應用

The Application of Modified Multi-layered Autologous Auricular Cartilage for Nasal Dorsum Augmentation

邱泳銓(Yung-Chuan Chiu) ； 凃智文(Chih-Wen Twu) ； 黃弘孟(Hung-Meng Huang) ； 徐欣健(Hsin-Chien Hsu)

《台灣耳鼻喉頭頸外科雜誌》 54卷2期 (2019/06) Pp. 68-76

https://doi.org/10.6286/jtohns.201906_54(2).068

摘要

背景：自體軟骨應用於鼻整形，已是行之有年的手術方式，主要的自體軟骨移植物有鼻中隔軟骨、耳郭軟骨及肋軟骨。亞洲人在鼻背高度普遍不足，故隆鼻手術對於鼻整形醫師來說，一直是一個重要的課題，本文藉由應用耳郭軟骨移植物，以改良式多層次堆疊的方式，來達到鼻背增高美化的效果。方法：本研究以回溯性分析，收集自2015年12月起至2018年07月間，於台北市立聯合醫院和平婦幼院區接受開放式鼻整形之患者，患者主訴皆是鼻背高度不足，而原因有外傷性、醫源性、修正性及美容性因素。根據患者鼻背高度缺失的情况，設計單側或雙測改良式多層次自體耳郭軟骨移植物，來改善鼻背高度。結果：自2015年12月起至2018年07月間，共計有13名患者接受以改良式多層次自體耳郭軟骨移植物於鼻背之增高，其中男性3名，女性10名，平均年齡36.7歲，耳郭軟骨移植物取自左側的患者共有6名，右側4名，雙側3名，耳郭軟骨移植物的取出皆由耳郭後面做切口。運用多層次堆疊的改良式自體耳郭軟骨移植物，成功應用於鼻背的增高。術後患者皆恢復良好，鼻小柱及耳後疤痕皆不明顯，傷口無感染、血腫、變形等併發症產生。結論：改良式多層次自體耳郭軟骨移植物可以簡單且安全地應用於鼻背的增高，術後無明顯併發症的發生，並且能呈現自然的鼻背外觀。

關鍵字

nasal dorsal augmentation ； open rhinoplasty ； modified multi-layered autologous auricular cartilage（鼻背增高 ； 開放式鼻成形術 ； 改良式多層次自體耳郭軟骨）

並列摘要

BACKGROUND: Autologous cartilage grafts are widely used for nasal dorsum augmentation. Various donor sites are available for harvesting, such as nasal septum cartilage, auricular cartilage, and ribs. Amongst the Asian population, deficiency of the nasal dorsum is common; therefore, nasal dorsum augmentation is important. In our study, we describe a multi-layered autologous auricular cartilage for nasal dorsum augmentation. METHOD: Our study was a retrospective analysis of enrolled patients who underwent open rhinoplasty at the Taipei City Hospital from December 2015 to July 2018. The origins of presenting complaints of nasal dorsum deficiency include traumatic, iatrogenic, cosmetic factors as well as requiring secondary revision. Unilateral or bilateral modified multi-layered autologous auricular cartilage grafts were designed to improve the nasal dorsum height based on the degree of nasal dorsum deficiency. RESULTS: During the study period, thirteen patients (3 males and 10 females) with an average age of 36.7 years received a modified multi-layered autologous auricular cartilage graft on nasal dorsum. There were 6 patients with cartilage donors on the left ear, 4 on the right ear, and 3 on bilateral ears. The harvesting of the auricular cartilage graft is made by a postauricular incision. Overall satisfaction was excellent. No postoperative scars were visible at the transcolumellar incision and donor sites. No wound infection, hematoma, or disfigurement was noted. CONCLUSIONS: Modified multi-layered autologous auricular cartilage is a feasible method for nasal dorsum augmentation without serious complication.

並列關鍵字

nasal dorsal augmentation ； open rhinoplasty ； modified multi-layered autologous auricular cartilage