自體肋軟骨移植物運用於加高型鼻成形術

Augmentation Rhinoplasty with Autogenous Costal Cartilage Graft

洪仲璟(Chung-Ching Hung) ； 高全祥(Chuan-Hsiang Kao) ； 蕭宇哲(Yu-Che Hsiao) ； 朱永祥(Yueng-Hsiang Chu) ； 王興萬(Hsing-Won Wang)

《台灣耳鼻喉頭頸外科雜誌》 41卷3期 (2006/06) Pp. 83-88

https://doi.org/10.6286/2006.41.3.83

摘要

背景：要成功矯正嚴重鼻樑過低、創傷性馬鞍鼻及人工鼻植入物產生的併發症，選擇適當的移植物來重建鼻樑高度是很重要的。本研究主要報告三軍總醫院耳鼻喉頭頸外科部以開放式鼻成形術，取用自體肋軟骨移植物來增加鼻樑高度的手術經驗。
方法：收集自2004年1月1日至2005年5月1日間，50名因先天或後天因素造成鼻樑過低或矽膠植入後產生的併發症的病患，接受取自體肋軟骨為移植物來改善鼻樑外形的鼻整形術，加以回溯性的分析研究。
結果：所有病患於全身麻醉下接受開放式鼻整形術，其中32名男性，18名女性。年齡分佈自18至56歲，平均年齡28歲。肋軟骨移植物多取自於右胸第七根肋骨，術後除1名發生傷口感染(2%)，接受保守性治療後痊癒；及1名發生移植物變形(2%)，於術後1年加以修正外，其餘恢復情況良好，美觀及功能皆獲得明顯改善。
結論：自體肋軟骨移植物用在加高型鼻整形術，可達預期的效果；在嚴重鼻樑過低，創傷性馬鞍鼻或修正性鼻整形手術時，可以是第一選擇的移植物，尤其可用在東方人矽膠植入隆鼻產生併發症的治療。

關鍵字

開放式鼻整形 ； 肋軟骨移植物 ； 加高型鼻整形

並列摘要

BACKGROUND: To successfully correct the severe low dorsum, traumatic saddle nose and complications of augmentation rhinoplasty with alloplastic material implantation, choosing the optimal graft to reconstruct the dorsal height is most important. The purpose of this study is to present our experience in augmentation rhinoplasty with costal cartilage graft by open rhinoplasty in the Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital.
METHODS: Fifty consecutive patients with severe low nasal dorsum or complications of silicone implantation underwent surgical correction by open rhinoplasty between January 1, 2004 and May 1, 2005. They all were treated using the autogenous costal cartilages to correct the unfavorable nasal dorsal profile. These cases were retrospectively reviewed.
RESULTS: All patients (32 males and 18 females) underwent open rhinoplasty under general anesthesia. Their ages ranged from 18 to 56 years with a mean age of 28 years. Most of the costal cartilage graft was harvested from the right seventh costal cartilage. The postoperative recoveries were uneventful except one patient with postoperative wound infection, which was solved after conservative treatment; and one patient complained of a noticeable warping of the costal cartilage graft, which was successfully corrected one year postoperatively.
CONCLUSION: We found that harvesting the costal cartilage for augmentation rhinoplasty leads to predictable, highly satisfactory outcomes. The autogenous costal cartilage can be the first choice for graft material in treating the severe low nasal dorsum, posttraumatic saddle nose deformity, and revision rhinoplasty, especially in treating the complications from the alloplastic material in Asian rhinoplasty.

並列關鍵字

open rhinoplasty ； rib cartilage graft ； augmentation rhinoplasty