自体耳廓软骨移植鼻尖成形术的解剖学基础及临床应用

发布时间：2018-04-07 18:49

本文选题：耳廓软骨　切入点：解剖学　出处：《北京协和医学院》2012年硕士论文

【摘要】：[目的] 1通过耳廓软骨的解剖学研究,指导临床手术中在保持耳廓形态不受影响的前提下最大量采取耳廓软骨。2分析中国人鼻尖形态学特点,应用耳廓软骨移植行鼻尖成形术,并观察及评价临床疗效。 [方法] 1通过尸体耳廓软骨的解剖,了解耳廓软骨支架的支撑体系特点,通过对耳廓软骨的解剖学和力学分析,找出维持耳廓形态的关键解剖部位,以及非维持形态的软骨部位,明确可采取软骨的解剖位置和范围,选择最佳手术切口位置,指导临床采取耳廓软骨时避免损伤耳部轮廓及支撑结构。 2临床观察并分析中国人鼻尖的形态特点,应用耳廓软骨移植鼻尖成形术,评价其疗效。 [结果] 1维持耳廓形态的结构包括耳轮、耳轮脚、对耳轮、对耳轮上脚及下角、耳屏、对耳屏,对耳轮下脚、耳轮脚、耳屏间切迹下方耳甲与外耳道后壁移行区及耳甲腔内侧缘与颅骨接触紧密,维持耳廓的轮廓和耳颅角的形成。可采取软骨位置包括耳甲艇、耳甲腔及耳甲隆起的外侧部。2手术最佳切口选在耳廓后方耳颅沟内。3根据临床患者鼻尖缺陷的特点,将鼻尖形态分成两类：(1)鼻尖突出度不足,鼻尖旋转角基本正常；(2)鼻尖突出度不足,鼻尖旋转角过大。临床应用耳廓软骨移植鼻尖成形术,术后效果良好,鼻尖外形明显改善。 [结论] 耳廓软骨能够够提供足够量的移植物行鼻尖成形术。中国人普遍存在的鼻尖部缺陷为鼻小柱短,鼻尖突出度不足,旋转度过大。通过耳廓软骨移植,增加鼻小柱支撑力,提高鼻尖突出度、丰满鼻尖下小叶以及减小鼻尖旋转角,充分改善鼻尖形态,是一种疗效肯定、结果满意的手术方式。
[Abstract]:[Objective]
1, through the anatomical study of auricular cartilage and guiding the clinical operation, we should take the most ear cartilage.2 to analyze the morphological characteristics of the nasal tip of the Chinese people, and apply auricular cartilage transplantation to do the nasal tip plasty, and observe and evaluate the clinical efficacy.
[method]
1 by the autopsy of auricular cartilage, understand the characteristics of auricle cartilage scaffold support system, through the analysis of auricular cartilage anatomy and mechanics, find out the key to maintaining the pinna morphology anatomy and maintain cartilage part of the form, can be taken to clear anatomical position and range of cartilage, choose the best surgical incision position, avoid injury and contour support structure for guiding clinical ear auricle cartilage.
2 the morphological characteristics of the Chinese nasal tip were observed and analyzed, and the auricular cartilage was used to transplant the tip of the nose to evaluate the curative effect.
[results]
1 maintain the ear form structure includes the helix, antihelix crus of helix, antihelix, foot and corner, tragus, antitragus, antihelix crus, foot, intertragic notch below the ear canal wall and transitional zone and concha margin of the skull close contact, maintain the shape of the ear the profile contour and the cranioauricular angle. Can take the position including the concha cartilage, best incision lateral.2 surgery and auricular concha swelling in auricle rear cranioauricular ditch.3 according to the characteristics of defects of nasal tip patients, the nose shape is divided into two categories: (1) the outstanding problems, the tip of the nose the rotation angle is normal; (2) the tip protrusion, tip rotation. Clinical application of auricular cartilage graft in nasal tip plasty, postoperative effect is good, the appearance of the nasal tip was significantly improved.
[Conclusion]
Can provide the plant for auricular cartilage nasal tip plasty shift a sufficient amount of defects of nasal tip. Chinese for nasal columella short nose, prominent problems, rotating through the large. Through auricular cartilage transplantation, increase the columella support force, improve the nasal tip protrusion, plump nose lobule and decreasing tip rotation angle, fully improve the nose shape, is an effective surgical method, with satisfactory results.

【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R765.9

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