ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ TIỂU TRỤ NGẮN, LỆCH VÀ ĐỈNH MŨI LỆCH BẰNG SỤN SƯỜN TỰ THÂN TRÊN BỆNH NHÂN ĐÃ PHẪU THUẬT KHE HỞ MÔI MỘT BÊN

Abstract

Short, deviated columella, and deviated nasal tip are two common deformities in patients with unilateral cleft lip. The choice of surgical technique and material for correcting these deformities is always a challenge for surgeons. Autologous materials are increasingly used by many authors to limit the complications of artificial materials, among which costal cartilage is an autologous material with the advantages of firmness and abundance, making it a popular choice for many surgeons worldwide. However, it is not yet widespread in Vietnam. Objectives: To evaluate the treatment outcomes in patients with prior unilateral cleft lip repair who underwent surgery to correct short, deviated columella, and deviated nasal tip using autologous costal  cartilage at Cho Ray Hospital. Research method: This is a clinical intervention before-after comparison study. Patients with prior unilateral cleft lip repair but still had nasal deformities including short, deviated columella, and deviated nasal, underwent  surgery to reconstruct the columella and nasal tip using autologous costal cartilage at the Aesthetic Plastic Surgery Department of Cho Ray Hospital from January 2018 to October 2022. Autologous costal cartilage was sliced ​​and created grafts for the columella and nasal tip. Surgical results were assessed at 1 month and 6 months after surgery. Results: A total of 39 patients with nasal deformities after prior cleft lip repair were included in the study. All patients had both short columella and deviated columella (accounting for 100% of cases). The majority of cases (69.2%) used one septal extension graft (SEG) to extend the septum.  89.7% of cases used one shield graft (SG) and 82.1% of cases used two cap grafts (CG). After surgery, 97.4% of cases showed an improvement in the deviated nasal tip, and 100% showed an improvement in short columella and deviated columella. Conclusion: Surgical treatment of short columella, deviated columella, and deviated nasal tip with autologous costal cartilage had yielded good results. Autologous costal cartilage is considered a safe and effective material for shaping nasal deformities in patients with prior unilateral cleft lip repair.