鼻头端肥大的分型及其治疗策略

摘要

Objective To classify the nasal tip hypertrophy according to the anatomic characters,so as to select the proper treatment methods.Methods From Jan.2010 to Mar.2012,92 cases (aged 21-46 years,average 29 years old) with nasal tip hypertrophy were classified as soft tissue hypertrophy,the alar cartilage hypertrophy,separation of alar cartilage,secondary tip hypertrophy after operation,and compound hypertrophy.Treatment methods were selected according to the hypertrophy type,including soft tissue thinning by medicine or operation,alar cartilage trimming and remodeling,autogenous ear and nasal septal cartilage grafts for enlongation or remodeling of nasal tip or columella.Results The follow-up period was 3 months to one year.The nasal tip hypertrophy was corrected obviously with a natural and harmonious appearance.The results were evaluated by patients as perfect in 59 cases,good in 26 cases and medium in 7 cases.Conclusion Satisfactory results can be achieved for the nasal tip hypertrophy with appropriate methods according to the anatomic classification.%目的 根据患者鼻头端的不同解剖特点,将鼻头端肥大分为软组织肥厚型、鼻翼软骨肥厚型、分离型鼻翼软骨、整形不当致鼻头肥大型、复合型鼻头肥大5个类型,提出各型鼻头端肥大的针对性治疗策略.方法 2010年1月至2012年3月,临床治疗92例鼻头端肥大患者,年龄21～46岁,平均29岁.根据不同分型采用不同手术方式,包括注射确炎舒松和手术减薄、鼻翼软骨分区塑形、耳软骨、鼻中隔软骨移植鼻尖成形和(或)鼻延长、鼻孔成形、鼻小柱延长等.结果 术后随访3个月至1年,患者鼻头均明显缩小,鼻翼沟重塑后轮廓分明,鼻部各亚单位比例协调,鼻背弧度自然.复诊结合术前、术后照片比较进行满意度评价:92例中优59例,良26例,一般7例.结论 根据鼻头端肥大的不同病因,先确定所属解剖类型,再采取相应的治疗策略,才能取得最好的整形美容效果.