Kết quả tạo hình mũi theo phương pháp tái cấu trúc bằng sụn sườn tự thân

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Tác giả: Quang Hùng Đỗ, Thị Hồng Vinh Phan

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2024

Mô tả vật lý: tr.102

Bộ sưu tập: Metadata

ID: 341834

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Đặt vấn đề: Bệnh nhân tạo hình mũi với nhiều biến chứng như lộ sống, co rút, lệch … bệnh nhân bị sụp khối mũi trán do chấn thương, dị tật bẩm sinh, dị ứng với vật liệu nhân tạo, bệnh nhân chỉ muốn tạo hình mũi bằng vật liệu tự thân được lựa chọn tạo hình mũi tái cấu trúc bằng sụn sườn tự thân. Báo cáo trường hợp: Báo cáo hàng loạt ca lâm sàng được thực hiện phẫu thuật nâng mũi mũi tái cấu trúc bằng sụn sườn tự thân tại bệnh viện Chợ Rẫy từ 26 tháng 5 năm 2020 đến 26 tháng 5 năm 2021. Bàn luận: Đa số BN từng phẫu thuật mũi ít nhất 1 lần (chiếm tỉ lệ 86,6%), tỉ lệ BN phẫu thuật mũi nhiều lần trước đây (2 - 3 lần) là 26,6%. Kết quả thẩm mỹ: Sau phẫu thuật, các BN có sự thay đổi đáng kể các chỉ số nhân trắc mũi, với chiều dài sống mũi tăng lên từ 4,87 cm thành 5,14 cm, chiều cao chóp mũi được đẩy lên từ 1,56 cm thành 1,98 cm, chiều rộng xương cánh mũi được thu hẹp lại từ 1,29 cm còn 1,16 cm, chiều rộng của cánh mũi cũng nhỏ lại từ 2,17 cm còn 2,0 cm, độ nhô trụ mũi được đẩy lên từ - 0,25 độ thành 0,12 độ, góc mũi trán giảm xuống từ 151,66 còn 142,73 độ, góc mũi môi cũng giảm từ 99,86 còn 91,4 độ. Kết quả chức năng: 100% BN giữ được chức năng thông khí bình thường của mũi. Sau 6 tháng phẫu thuật: Có 4 trường hợp bị lệch vách ngăn nhẹ, chiếm tỉ lệ 26,7%. 93,3% BN rất hài lòng với quá trình điều trị và kết quả phẫu thuật, tỉ lệ BN chỉ đạt mức hài lòng là 6,7%, và không có BN nào không hài lòng với kết quả phẫu thuật Kết luận: Phương pháp nâng mũi tái cấu trúc bằng sụn tự thân, tỷ lệ thành công cao, áp dụng được cho những trường hợp mũi phức tạp, quá trình hậu phẫu nhẹ nhàng, ít biến chứng.Abstract Background: The patients had previous rhinoplasty plastic surgery with complications such as exposing the spine, shrinking, deviating… Patients with collapsing nose and frontal, patients with deformities of the nose and the patients have history of allergy to artificial materials, the patients only wanted to shape the nose with autologous materials is selected to reconstruct the nose with autologous rib cartilage. Case presentation: Report on a series of clinical cases performed by autologous rib cartilage reconstruction rhinoplasty at Cho Ray hospital from May 26, 2020 to May 26, 2021. Discussion: The majority of patients had nose surgery at least once (accounting for 86.6%), the rate of patients with many previous nose surgeries (2 - 3 times) was 26.6%. After surgery, the patients had a significant changed in the nasal anthropometric indexes, with the length of the bridge of the nose increased from 4.87cm to 5.14cm, the height of the tip of the nose was pushed up from 1.56 cm to 1.98 cm, the width of the alar bone is narrowed from 1.29 cm to 1.16 cm, the width of the alar is also reduced from 2.17 cm to 2.0 cm, the protrusion of the nasal column is pushed increased from - 0.25 degrees to 0.12 degrees, the angle of the nose and forehead decreased from 151.66 to 142.73 degrees, the angle of the nose and lips also decreased from 99.86 to 91.4 degrees. Functional results: 100% of patients kept the normal ventilation function of the nose. After surgery 6 months: There were 4 cases of slight deviation of the septum, accounting for 26.7%. And 93.3% of patients were very satisfied with the treatment process and surgical results, the rate of satisfied patients was only 6.7%, and no patient was dissatisfied with the surgical results. Conclusions: Rhinoplasty by method reconstruction by autologous costal cartilage, has a high success rate, can be applied to complicated nasal morphology, gentle postoperative process, few complications. DOI: 10.59715/pntjmp.2.3.12

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