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Title: [Application of autologous costal cartilage-based open rhinoplasty in secondary unilateral cleft lip nasal deformity].
Author: Ren P, Fan F, Zheng R, Xu Y, You J, Wang H, Zhang X, Tian L, Lin G.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2021 Aug 15; 35(8):1021-1026. PubMed ID: 34387432.
Abstract:
OBJECTIVE: To evaluate the effectiveness of autologous costal cartilage-based open rhinoplasty in the correction of secondary unilateral cleft lip nasal deformity. METHODS: Between January 2013 and June 2020, 30 patients with secondary unilateral cleft lip nasal deformity were treated, including 13 males and 17 females; aged 14-41 years, with an average of 21.7 years. Among them, 18 cases were cleft lip, 9 cases were cleft lip and palate, and 3 cases were cleft lip and palate with cleft alveolar. The autologous costal cartilage-based open rhinoplasty was used for the treatment, and the alar annular graft was used to correct the collapsed alar of the affected side. Before operation and at 6-12 months after operation, photos were taken in the anteroposterior position, nasal base position, oblique position, and left and right lateral positions, and the following indicators were measured: rhinofacial angle, nasolabial angle, deviation angle of central axis of columella, nostril height to width ratio, and bilateral nasal symmetry index (including nostril height, nostril width, and nostril height to width ratio). RESULTS: The incisions healed by first intention after operation, and no complications such as acute infection occurred. All 30 patients were followed up 6 months to 2 years, with an average of 15.2 months. During the follow-up, the patients' nasal shape remained good, the tip of the nose and columella were basically centered, the back of the nose was raised, the collapse of the affected side of nasal alar and the movement of the feet outside the nasal alar were all lessened than preoperatively. The basement was elevated compared to the front, and no cartilage was exposed or infection occurred. None of the patients had obvious cartilage absorption and recurrence of drooping nose. Except for the bilateral nostril width symmetry index before and after operation, there was no significant difference ( t=1.950, P=0.061), the other indexes were significantly improved after operation when compared with preoperatively ( P<0.05). Eleven patients (36.7%) requested revision operation, and the results were satisfactory after revision. The rest of the patients' nasal deformities were greatly improved at one time, and they were satisfied with the effectiveness. CONCLUSION: Autologous costal cartilage-based open rhinoplasty with the alar annular graft is a safe and effective treatment for secondary unilateral cleft lip nasal deformity. 目的: 探讨开放式自体肋软骨移植鼻整形术在单侧唇裂继发鼻畸形整复中的治疗效果。. 方法: 2013 年 1 月—2020 年 6 月，收治 30 例单侧唇裂继发鼻畸形患者。男 13 例，女 17 例；年龄 14～41 岁，平均 21.7 岁。其中唇裂 18 例，唇腭裂 9 例，唇腭裂伴齿槽嵴裂 3 例。应用开放式自体肋软骨移植鼻整形术治疗，术中使用肋软骨鼻翼环状移植物矫正患侧塌陷的鼻翼。术前及术后 6～12 个月摄正位、鼻基底位、斜位及左右侧位照片，测量以下指标：鼻面角、鼻唇角、鼻小柱中轴偏斜角、同侧鼻孔高度与宽度比、鼻部双侧对称指数（包括鼻孔高度、鼻孔宽度及鼻孔高度与宽度比的对称指数）。. 结果: 术后切口均Ⅰ期愈合，未出现急性期感染等并发症。30 例患者均获随访，随访时间 6 个月～2 年，平均 15.2 个月。随访期间患者鼻部形态保持良好，鼻尖及鼻小柱基本居中，鼻背抬高，患侧鼻翼塌陷、鼻翼外侧脚外移等均较术前减轻，双侧鼻孔间差异减小，患侧鼻基底较术前抬高，无软骨外露、感染等发生。患者均无明显的软骨吸收及鼻翼下垂复发。除双侧鼻孔宽度对称指数手术前后比较差异无统计学意义（ t=1.950， P=0.061）外，其余各指标术后均较术前显著改善，差异有统计学意义（ P<0.05）。11 例（36.7%）患者要求二次手术，再次修复术后效果满意；其余患者鼻畸形均一次性得到较大改善，患者对手术效果满意。. 结论: 开放式自体肋软骨移植鼻整形术可以有效修复单侧唇裂继发鼻畸形，手术效果稳定可靠。.

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