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目的:探讨自体耳软骨联合耳后筋膜在初次鼻整形的应用价值和临床效果。方法:2019年1月至2022年1月，北京协和医院整形美容外科收治初次鼻整形患者31例，男1例、女30例；年龄17～43岁，平均24.3岁。均用自体耳软骨及耳后筋膜材料进行鼻整形。随访6～24个月，平均18个月，比较患者术前以及术后6、12个月的鼻长度、鼻尖突出度、鼻根、鼻背高度变化。结果:31例患者均用自体耳软骨及耳后筋膜材料进行鼻整形。术后6个月与术前比较，鼻长度增加(4.4±0.7) mm( t＝3.17， P＝0.025)，鼻尖突出度增加(4.6±0.5) mm( t＝6.45， P＝0.001)，鼻根高度增加(3.1±0.4) mm( t＝8.21， P＝0.001)，鼻背高度增加(2.6±0.5) mm( t＝5.79， P＝0.015)。术后12个月与术前比较，患者鼻长度增加(4.3±0.6) mm( t＝2.99， P＝0.030)，鼻尖突出度增加(4.2±0.4) mm( t＝5.12， P＝0.005)，鼻根高度增加(2.9±0.3) mm( t＝6.86， P＝0.005)，鼻背高度增加(2.2±0.4) mm( t＝4.14， P＝0.020)，术后6个月与12个月比较，各项观察指标差异无统计学意义(均 P>0.05)。 结论:初次鼻整形中用自体耳软骨和耳后筋膜能够取得较好的治疗效果，术后鼻外形美观自然，持久稳定，且并发症少，值得临床应用。

Objective:To investigate the application and clinical effect of autologous ear cartilage combined with retroauricular fascia in primary rhinoplasty.Methods:A retrospective analysis was conducted on 31 primary rhinoplasty patients admitted to our hospital from January 2019 to January 2022, including 1 male and 30 females; the age range was 17-43 years, with an average of 24.3 years. The patients were followed up for 6-24 months, with an average of 18 months. The changes of nasal length, nasal tip projection, nasal height and nasal dorsum height were compared before operation, 6 months and 12 months after operation respectively.Results:All the 31 patients underwent rhinoplasty using autologous ear cartilage and retroauricular fascia materials. Six months after surgery, the patient′s nasal length increased by (4.4±0.7) mm ( t=3.17, P=0.025), nasal tip projections increased by (4.6± 0.5) mm ( t=6.45, P=0.001), nasal height increased by (3.1±0.4) mm ( t=8.21, P=0.001), and nasal dorsum height increased by (2.6±0.5) mm ( t=5.79, P=0.015). 12 months after surgery, the patient′s nasal length increased by (4.3±0.6) mm ( t=2.99, P=0.030), nasal tip projections increased by (4.2±0.4) mm ( t=5.12, P=0.005), nasal height increased by (2.9±0.3) mm ( t=6.86, P=0.005), and nasal dorsum height increased by (2.2±0.4) mm ( t=4.14, P=0.020). There was no significant difference in the observation indicators at 6 and 12 months after surgery ( P>0.05). Conclusions:The application of autologous ear cartilage and retroauricular fascia in primary rhinoplasty has prominent cosmetic effect, beautiful and natural nasal shape, stable long-term effect and few complications, which is worthy of clinical promotion.