摘要
目的:阐述中国人鼻鹦鹉嘴样畸形矫治的手术策略,并评估术后效果。方法:回顾性分析2021年1月至2022年12月中南大学湘雅二医院整形美容外科收治的鼻鹦鹉嘴样畸形患者资料。根据患者鼻畸形的病因和严重程度,分别通过鼻中隔前脚切除、鼻尖支撑重建、鼻穹窿中段重建、鼻尖上区皮肤切除等方法进行个性化矫治。通过鼻尖上区畸形评分(0~3分,得分越高,畸形越明显)、视觉模拟评分法(VAS)美学评分(0~10分,得分越高,畸形越明显)对患者术前与术后的鼻尖上区美学效果进行评估;通过鼻整形结果评估(ROE)量表对术后鼻功能与美学效果进行患者满意度自评,总分100分,得分越高代表满意度越高。正态分布计量资料以x±s表示,采用配对t检验进行分析;非正态分布计量资料以M(Q_(1),Q_(3))表示,采用Wilcoxon符号秩检验进行分析。结果:共纳入53例患者,男7例,女46例,年龄19~45岁,平均29岁。15例患者行初次隆鼻术,38例患者行二次隆鼻术;鼻轻度畸形5例,中度畸形25例,重度畸形23例。术后随访6~17个月,平均9.5个月。患者的鼻尖上区美学效果有明显改善,鼻尖上区畸形评分由术前的2(2,3)分降低至术后的0(0,0)分(Z=-6.58,P<0.001),VAS美学评分由术前的(7.47±1.73)分改善为术后的(1.79±1.67)分(t=-25.61,P<0.001)。患者对术后的鼻部功能与美学的满意度较高,ROE量表得分为(82.45±11.55)分;无明显鼻尖下垂、皮肤坏死、明显瘢痕增生等情况发生。结论:根据鹦鹉嘴样畸形的严重程度和病因选择合适的手术方法进行矫治可获得良好的效果,术后患者鼻尖上区美学效果明显改善,患者满意度高。
Objective To evaluate the effectiveness of surgical methods for correcting pollybeak deformity in Chinese rhinoplasty.Methods A retrospective chart review was conducted for patients who underwent pollybeak correction between January 2021 and December 2022 at the Department of Plastic and Aesthetic(Burn)Surgery,the Second Xiangya Hospital of Central South University.Individualized correction was tailored based on the etiology and severity of the nasal deformity of each patient,involving techniques such as resection of the anterior part of the nasal septum,reconstruction of nasal tip support,reconstruction of the middle part of the nasal vault,and excision of skin in the upper region of the nasal tip.A modified classification system for pollybeak deformity,the supratip fullness rating scale(SFRS),was developed to evaluate supratip fullness(0-3 points,with higher scores indicating more apparent deformity).The patients aesthetic outcomes were assessed by surgeons using the visual analogue scale(VAS)(0-10 points,with higher scores indicating more apparent deformity),and patient self-assessed using the rhinoplasty outcome evaluation(ROE)questionnaire(0-100 points,with higher scores indicating higher satisfaction).The measurement data of normal distribution was expressed as Mean±SD and analyzed by paired t-test;the measurement data of non-normal distribution was expressed as M(Q_(1),Q_(3))and analyzed by Wilcoxon signed rank test.Results In a cohort study of 53 rhinoplasty patients(7 male,46 female;age range 19-45 years,mean 29 years),comprising 15 primary and 38 secondary surgeries,nasal tip deformities were evaluated.Deformities were classified as mild(5 cases),moderate(25 cases),and severe(23 cases).Over a follow-up period of 6-17 months(mean 9.5 months),significant aesthetic improvements in the nasal tip region were observed.The SFRS scores decreased from 2(2,3)preoperatively to 0(0,0)postoperatively(Z=-6.58,P<0.001),and VAS scores decreased from 7.47±1.73 to 1.79±1.67(t=-25.61,P<0.001).High patient satisfaction
作者
赵弘历
王先成
孙杨
熊祥
孟宪熙
李文波
乔治华
杨开
曾伟良
田毅
Zhao Hongli;Wang Xiancheng;Sun Yang;Xiong Xiang;Meng Xianxi;Li Wenbo;Qiao Zhihua;Yang Kai;Zeng Weiliang;Tian Yi(Department of Plastic and Aesthetic(Burn)Surgery,the Second Xiangya Hospital of Central South University,Changsha 410000,China)
出处
《中华整形外科杂志》
CSCD
北大核心
2024年第2期156-162,共7页
Chinese Journal of Plastic Surgery
基金
国家自然科学基金(82272283)。
