目的 评估旋转推进瓣结合皮肤楔形切除法鼻翼缩小术的临床疗效.方法 自2018年4月至2023年1月,上海美莱医疗美容门诊部收治23例"三宽"型鼻翼(即鼻翼外扩导致的鼻翼间距过宽、鼻槛过宽和鼻翼基底间距过宽)求美者,采用鼻翼"回旋镖"形切口及鼻翼基底外下方皮肤楔形切除,将鼻翼旋转内收以改善鼻翼宽大.于术前、术后6个月测量单侧鼻槛宽度(sill width,SW)、鼻翼基底宽度(alar base width,ABW)和鼻翼宽度(inter-alar width,IAW),并采用配对t检验对手术前后差异进行统计学分析.结果 与术前相比,术后6个月SW、ABW和IAW三者与内眦间距离(inter-canthal distance,ICD)的比值皆显著减小,差异有统计学意义(P＜0.05).所有求美者无感染、皮瓣血运不良及鼻孔畸形等并发症发生,鼻孔不对称者1例,切口痂下愈合者2例,求美者对正位和基底位的鼻翼改善效果均满意.结论 旋转推进瓣结合皮肤楔形切除法能有效地减少鼻槛宽度和鼻翼基底宽度,显著改善鼻翼的正位观和基底位观.此方法并发症发生率较低,求美者满意度较高.
Alar base reduction by advanced rotation flap combined with skin wedge excision
Objective To evaluate the effectiveness of advanced rotation flap(ARF)combined with skin wedge excision(WE)on the alar base reduction.Methods Twenty three patients who presented with broad alar,broad nasal sill and broad nasal base received ARF+WE alar base reduction and were followed up for 6 months.The alar width was reduced by boomerang incision ARF+WE.The uni-lateral sill width,alar base width and inter-alar width were measured before operation and 6 months after the operation.The difference be-fore and after operation was statistically analyzed by paired t test.Results The ratio of the unilateral sill width,alar base width and in-ter-alar width to the inter-canthal distance were statistically decreased post-operation.None of the patients suffered from infection,poor blood circulation of the skin flap and malformation of the nostril.Nostril asymmetry occurred in 1 case and secondary wound healing oc-curred in 2 cases.The nasal base width in both frontal and basal view were improved significantly.Conclusion The ARF+WE alar base reduction technique can reduce the SW,IAW and ABW effectively,it's a safe and easily applied technique.
Nasal base reductionNasal sill widthNasal base widthAdvanced rotation flap
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