- 期刊
使用顱頂骨矯治馬鞍鼻－三例報告
Correction Saddle Nose with Calvarial Bone - Report of Three Cases
摘要
鼻骨的重建對於馬鞍鼻的病患是一種重要的手術，而鼻骨的重建需要一種能當作結構支撐的適當物質。我們一般常使用的材質包括異質初器（alloplasts）、軟骨及硬骨。在鼻骨的重建上，異質初器因為可能造成附近組織的感染因而使用上受到限制。而使用軟骨當作材質則有較高的吸收率及易變形的缺點。硬骨則具有極佳的支撐力及易被雕塑的功能。使用顱頂骨的優點則是有較小的疤痕及功能上的缺陷並且可縮短住院天數及較低的吸收率。本科去年共有3例馬鞍鼻患者接受鼻整型術並使用顱頂骨作為鼻重建的材料。1例為在他院使用異質初器而造成附近組織的感染，後來改用顱頂骨作為材料。另兩例為馬鞍鼻的病患，直接用顱頂骨作為鼻重建的材料。追蹤至今無任何併發症且改善馬鞍鼻的效果，病人亦感到相當滿意。因此，對於馬鞍鼻的鼻成型術，顱頂骨是值得考慮的材料。
並列摘要
Nasal reconstruction is an important procedure for patients with a saddle nose. Nasal reconstruction requires adequate substance for structural support and materials for implants and grafts include alloplasts, cartilages and bones. Alloplastic implants exhibit higher rates of infection and are therefore used less frequently. Cartilage is an alternative, which has a significant resorption rate and a tendency to warp, limiting its use. Another implant material is autologous bone, which can provide a rigid substance, excellent support and can be contoured. Three patients underwent rhinoplasty using autologous calvarial bone between 1998 and 2000. The first patient was a 43 year-old male whose nose had been reconstructed with an alloplastic graft of silicon at another hospital but infection and fistula had developed. The second patient was a 55 year-old female with a maxillary sinus carcinoma who underwent the operation and radiotherapy. The third patient was a 52 year-old female who had undergone external fixation with titanium but had suffered recurrent infection. In all three cases, calvarial bone was used for nasal reconstruction and during follow up there were no complications noted and results were quite satisfactory. In conclusion, calvarial bone augmentation is an effective implant for saddle nose rhinoplasty.