融合吊带-口轮匝肌鼻浅层复合皮瓣：亚洲鼻整形术中用于鼻小柱基底增强的软组织悬吊技术

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中文摘要

在亚洲鼻整形术中，面部中部和谐常需要同时改善鼻唇角及鼻小柱基底突出度。传统结构移植物——鼻小柱支撑、鼻中隔延伸移植物及前颌骨移植物——可提供可靠支撑，但可能增加鼻尖僵硬或扰乱上唇-鼻小柱关系。近期解剖学研究已确定融合吊带及口轮匝肌鼻浅层（SOON）是鼻尖动力学的关键软组织贡献者。2022年至2025年间，对214例连续亚洲鼻整形患者（179例初次；其余为保留融合吊带-SOON连续性的选定修复病例）实施了融合吊带-SOON复合皮瓣（FSCF）。适应证包括鼻唇角锐利且前鼻棘或前颌骨支撑不足。通过SMAS下入路，将融合吊带及SOON作为8至10毫米筋膜肌肉复合皮瓣掀起，并用尾侧鼻中隔软铰链或鼻中隔延伸移植物悬吊固定。对63例患者进行了三维Vectra分析。平均随访时间为12.4个月（范围6-24个月）。平均鼻唇角从93.4度增加至101.0度（+7.6度），鼻小柱基底突出度增加1.9毫米。可重复实现轻度、中度及重度分级改变。未发生重大并发症、上唇僵硬、表情畸形或FSCF相关修复。FSCF是一种可重复、基于解剖的动态技术，可改善鼻唇角及鼻小柱基底，同时保留上唇活动度，为亚洲鼻整形术中的刚性结构增强提供了一种平衡的替代方案。

英文摘要

In Asian rhinoplasty, midfacial harmony often requires concurrent enhancement of the nasolabial angle and columellar base projection. Conventional structural grafts-columellar struts, septal extension grafts, and premaxillary grafts-provide reliable support but may increase tip rigidity or disturb the upper lip-columellar relationship. Recent anatomical work has identified the fusion sling and the superficial orbicularis oris nasalis (SOON) as key soft-tissue contributors to nasal tip dynamics. Between 2022 and 2025, the fusion sling-SOON composite flap (FSCF) was performed in 214 consecutive Asian rhinoplasty patients (179 primary; the remainder selected revision cases with preserved fusion sling-SOON continuity). Indications included an acute nasolabial angle with inadequate anterior nasal spine or premaxillary support. Through a sub-superficial musculoaponeurotic system approach, the fusion sling and SOON were elevated as an 8- to 10-mm fasciomuscular composite flap and stabilized with a caudal septal soft-hinge or septal extension graft suspension. Three-dimensional Vectra analysis was performed in 63 patients. Mean follow-up was 12.4 months (range, 6-24 mo). Mean nasolabial angle increased from 93.4-degree angle to 101.0-degree angle (+7.6-degree angle), and columellar base projection increased by 1.9 mm. Graded mild, moderate, and large changes were reproducibly achieved. No major complications, upper lip stiffness, animation deformities, or FSCF-related revisions occurred. The FSCF is a reproducible, anatomy-based dynamic technique that improves the nasolabial angle and columellar base while preserving upper lip mobility, offering a balanced alternative to rigid structural augmentation in Asian rhinoplasty.