筛骨垂直板移植：亚洲继发性唇裂鼻畸形中的功能与亚单位联合重建

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中文摘要

背景： 亚洲继发性唇裂鼻整形术需要坚固的移植材料。自体肋软骨虽然常用，但受限于供区并发症、钙化和变形。本研究介绍了一种使用筛骨垂直板（PPE）的重建方案，以克服这些局限性。
方法： 一项回顾性研究纳入130例接受继发性唇裂鼻整形术的患者，其中49例在2017年9月至2025年8月期间使用PPE和鼻中隔软骨。手术技术将L形支撑重建与软组织亚单位及口轮匝肌复位相结合。对具有代表性的亚组（n=12）使用NOSE量表和ROE进行客观评估。
结果： 总体而言，98%的患者（48/49）在随访期间表现出较高的主观满意度。并发症罕见（感染率2%，经保守治疗处理）。定量亚组分析显示功能和美学均有显著改善：NOSE评分中位数从11.00降至3.50（p=0.033），ROE评分均值从8.17±2.41升至20.42±4.27（p<0.001）。
结论： 在亚洲继发性唇裂鼻整形术中，自体PPE移植是肋软骨的一种可靠、结构坚固的替代方案。它能有效恢复亚单位和谐与气道通畅，且供区并发症极少。
证据等级III： 本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整说明，请参阅目录或在线作者须知 www.springer.com/00266。本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整说明，请参阅目录或在线作者须知 www.springer.com/00266。

英文摘要

BACKGROUND: Asian secondary cleft rhinoplasty requires robust grafting. Autologous costal cartilage, while common, is limited by donor site morbidity, calcification, and warping. This study introduces a reconstructive protocol using the perpendicular plate of the ethmoid (PPE) to overcome these limitations.
METHODS: A retrospective review included 130 patients who underwent secondary cleft rhinoplasty, with 49 of them using PPE and septal cartilage between September 2017 and August 2025. The surgical technique integrated L-strut reconstruction with soft tissue subunit and orbicularis oris muscle repositioning. A representative subset (n = 12) was evaluated using the NOSE scale and ROE to objectively assess outcomes.
RESULTS: Overall, 98% of patients (48/49) expressed high subjective satisfaction over the follow-up. Complications were rare (2% infection rate, managed conservatively). Quantitative subset analysis demonstrated significant functional and aesthetic improvements: median NOSE scores decreased from 11.00 to 3.50 (p = 0.033), and mean ROE scores surged from 8.17 ± 2.41 to 20.42 ± 4.27 (p < 0.001).
CONCLUSION: Autologous PPE grafting is a reliable, structurally robust alternative to costal cartilage in Asian secondary cleft rhinoplasty. It effectively restores subunit harmony and airway patency with minimal donor site morbidity.
LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .