自体肋软骨结合硅胶假体整形术与鼻中隔偏曲合并歪鼻同期矫正术对外伤性歪鼻美学改善效果的对比研究

Comparison of the aesthetic improvement effect of autologous costal cartilage and silicone prosthesis and simultaneous correction of nasal septum deviation and deviated nose for traumatic deviated nose

摘要:

目的 对比自体肋软骨结合硅胶假体整形术与鼻中隔偏曲结合歪鼻同期矫正术对外伤性歪鼻美学改善效果。方法 选取2019年6月—2021年5月安徽医科大学第一附属医院收治的外伤性歪鼻患者108例，采用随机数字表法分为整形组（自体肋软骨结合硅胶假体整形术）、矫正组（鼻中隔偏曲结合歪鼻同期矫正术），每组54例。比较两组患者鼻形态改善指标、鼻通气功能、满意度及术后并发症发生情况。结果 两组患者手术前后鼻梁偏斜角度、鼻尖突出度及鼻额角差值比较，差异有统计学意义（P <0.05），整形组大于矫正组。两组患者手术前后鼻腔容积、鼻腔最小横截面积及鼻腔呼气吸气阻力差值比较，差异有统计学意义（P <0.05），整形组手术前后鼻腔容积、鼻腔最小横截面积的差值大于矫正组，鼻腔呼气吸气阻力的差值小于矫正组。两组术后总满意度比较，差异无统计学意义（P >0.05）；两组患者术后并发症总发生率比较，差异无统计学意义（P >0.05）。结论 外伤性歪鼻患者采用自体肋软骨结合硅胶假体整形术在改善鼻形态、鼻腔容积方面优于鼻中隔偏曲结合歪鼻同期矫正术，在鼻腔最小横截面积、鼻腔呼气吸气阻力、满意度及安全性方面两种手术方式效果接近。

Abstract:

Objective To compare the aesthetic improvement effect of autologous rib cartilage combined with silicone prosthesis and deviated septum combined with simultaneous correction of deviated nose for traumatic deviated nose.Methods A total of 108 patients with traumatic deviated nose who were treated in our hospital from June 2019 to May 2021 were selected and randomly divided into plastic surgery group (using autologous costal cartilage combined with silicone prosthesis plastic surgery) and correction group (using nasal septum). Deviated combined with deviated nose correction surgery, 54 cases in each group. The nasal morphology improvement indicators, nasal ventilation function, satisfaction and postoperative complications were compared between the two groups.Results The deviation angle of the nasal bridge was decreased in both groups after operation (P < 0.05), and the prominence of the nose tip and the nose-frontal angle were increased (P < 0.05). The deviation angle of the nasal bridge in the plastic surgery group was lower than that in the correction group (P < 0.05), while the prominence of the nose tip and the nose-frontal angle were higher than those in the correction group (P < 0.05). After operation, the nasal volume and the minimum cross-sectional area of the nasal cavity increased (P < 0.05), and the nasal expiratory and inspiratory resistance decreased (P < 0.05). The nasal volume in the plastic surgery group was higher than that in the correction group (P < 0.05). There was no significant difference in the minimum cross-sectional area of the nasal cavity and the nasal expiratory and inspiratory resistance between the two groups after surgery (P > 0.05). There was no significant difference in the total postoperative satisfaction rate between the two groups (P > 0.05). There was no significant difference in the total incidence of postoperative complications between the two groups (P > 0.05).Conclusion In patients with traumatic deviated nose, autologous costal cartilage combined with silicone prosthesis plastic surgery is superior to nasal septum deviation combined with deviated nose correction in improving nasal shape and nasal cavity volume. The two surgical methods were similar in terms of satisfaction and safety.