髂嵴软骨移植修复唇裂鼻畸形的实验研究

【作者】 陶德韬；

【导师】 陶震江；

【作者基本信息】 南京医科大学 ， 口腔临床医学， 2006， 硕士

【摘要】 唇裂继发鼻畸形(secondary nasal deformities of cleft lip)是临床上常见的颌面部畸形，唇裂术后鼻畸形的修复方法甚多，包括软组织复位缝合、自体软骨移植、胚胎冷冻软骨移植、同种异体软骨移植、生物材料植入等，目前认为鼻畸形最满意的修复方法是在自体软骨移植的基础上，再行软组织的复位。目前自体软骨常用的软骨来源是鼻中隔软骨及耳甲软骨，二者均需至成年后进行；而鼻畸形的存在一定程度上会影响患者的心理健康，若早期行软骨移植修复鼻畸形则会给患者的心理健康带来一定的积极作用。唇裂患者常伴牙槽突裂，髂嵴是最常用的修复牙槽突裂的骨来源部位，在幼年时期髂嵴表面有一层较厚的软骨覆盖，若在修复牙槽嵴突裂的同期行髂嵴软骨(iliac crest cartilage，ICC)移植修复鼻畸形，则同时解决了早期修复鼻畸形和牙槽突裂两大问题。迄今为止，髂嵴软骨移植用于修复鼻畸形尚未见研究报道。本研究将新西兰大白兔(New Zealand white rabbits，NZWR)的髂嵴软骨和肋软骨(costal cartilage，CC)分别移植于自体鼻翼(alaenasi)软组织内及上颌骨表面，应用组织学及免疫组织化学方法研究髂嵴软骨移植后的组织学变化及生物学特性，并初步探讨其机制，以期为髂嵴软骨移植修复唇裂术后鼻畸形奠定理论和实验基础。 第一部分 目的：兔髂嵴软骨移植修复鼻畸形的动物模型的建立及软骨移植后的组织学变化。 材料和方法：新西兰大白兔8只(南京医科大学实验动物中心提更多还原

【Abstract】 Secondary nasal deformity of cleft lip is one of maxillofacial deformities. There are many sorts of methods for repairing the nasal deformity of cleft lip, including soft tissues reposition, auto-cartilage transplantation, freezing embryo-cartilage transplantation, variant-cartilage transplantation, synthetic materials implantation, et al. At present, septal cartilage and auricular concha cartilage are the source of most used, but these operations must be run after growth up. Nasal deformity must be influence patients’ psychological health, it would emerge effective if repair nasal deformity earlier. Cleft lip always accompany alveolar cleft, iliac crest is used bone resource the most to repair alveolar cleft. Surface of iliac crest coverage thick cartilage named iliac crest cartilage (ICC) at childhood, it would solve two deformities earlier period if transplant ICC to repair nasal deformity at the time of repair alveolar cleft. But auto-cartilage graft is always considered as the most satisfactory technique. However, studies on histological change of cartilage are fewer reported after auto-cartilage (such as costal cartilage, auricular concha cartilage) is transplanted in region of the nasal deformity. Especially, restoration of the nasal deformity of cleft lip by transplantation of ICC is still not reported. In this study, ICC and costal cartilage (CC) of New Zealand white rabbits (NZWR) were respectively transplanted into the soft tissue of alae nasi and onto the surface of更多还原