The Clinical Study Of Cavum Conchae Cartilage Combined With Expanded Polytetrafluoroethylene For Short Nose Deformity

ObjectiveCavum conchae cartilage combined with polytetrafluoroethylene(e-PTFE)is a new operation method to treat short nose deformity,now we introduce a modified surgical procedure and to investigate its therapeutic effect.MethodsThe data of nasal length,mandibular height,middle face length,nasal lip angle,nasal facial angle,nasal circumflex angle and nasal apex protrusion were collected by image pro-plus6.0 software before operation.Preliminary engraving of the prosthesis was carried out according to the measured data,the actual situation of the patient and the relevant aesthetic standards during the operation.Using open butterfly pterygoid incision,Fully dissociate the posterior space of the dorsal fascia of the nose,release the connection between cartilage,cartilage and skin.Take two pieces of vacum conchae cartilage,carve them into proper size,shape,one piece at a proper position with the nasal septum cartilage suture,another piece as a nasal columella and nasal alar cartilage sustentaculum.The two pieces of vacum conchae cartilage were modified according to the actual nasal anatomical structure after the implantation of the cartilage supporting structure of the chondroid cavity of ear to further deal with the details of the prosthesis so as to make the contour of the prosthesis natural and the tissue close to each other.Implantation of prosthesis and fixation with vacum conchae cartilage supporting structure.Covering the bridge of nose and nasal columella as a whole flap,operators see no tension and suture the operation incision.The related data were collected again after the operation to evaluate the degree of correction of the nasal shape.ResultsFrom January 2015 to January 2017,43 cases of short nasal deformity were corrected by the operation mode of vacum conchae cartilage combined with expanded polytetrafluoroethylene.All of them were primary nasal plastic surgery.Of these,37 were female and 6 were male,with an average age of 29 years(19~50 years).All cases did not meet the normal aesthetic standards of aesthetics: the nasal length was less than 1/3 of the middle face length,and less than the vertical height of the mandible,the nasal lip angle was larger than 90° in males and more than 95° in females,the nasal angle was less than 29° and the posterior angle of nasal apex was more than 60°.All patients were followed up for more than one year.The nasal physiological function was normal and no empty nasal syndrome appeared.The incision was healed in I stage,the skin of the operation area was not thinned and burst,no obvious surgical scar,1 case with slight nostril change and 1 case with nasal tip hypertrophy.The prosthesis was slightly skewed in 2 cases,and the prosthesis was corrected within half a year.no infection of prosthesis,exposure,absorption of auricular cartilage support,collapse and other complications occurred.the dorsal extension length increased 4.0~9.0 mm,average 5.1 mm,nasolabial angle reduced 5 to 15 degrees,9.3 degrees on average,nose protrusion increased 3.0~7.0 mm,average 4.5 mm,have received satisfactory results.ConclusionThe modified surgical procedure of cavum conchae cartilage combined with e-PTFE can prolong the nasal back length,reduce the nasolabial angle,increase the tip of the nose,the curative effect is reliable,can be used as a method to correct the short nose deformity.