Arslan Emrah, Majka Christopher, Polat Ayse
Department of Plastic and Reconstructive Surgery, Mersin University, Medical School, Zeytinlibahce Cad, 33079, Mersin, Turkey.
Aesthetic Plast Surg. 2007 Jul-Aug;31(4):365-71. doi: 10.1007/s00266-006-0113-9.
Diced cartilage grafts have long been used in rhinoplasty. Along with their various reported advantages, they also have some disadvantages. The irregular resorption rate of the engrafted mass is one of the major issues noted with diced cartilage grafts. An explanation for the unpredictable resorption rate has not yet been elucidated. This study aimed to determine the role of traumatized versus nontraumatized cartilage as the source of diced cartilage grafts.
This study included the noses of 32 patients (19 traumatized noses and 13 nontraumatized noses) who underwent surgery using Surgicel-wrapped diced cartilage grafts.
The most remarkable result noted in this study was that a Surgicel-wrapped diced cartilage graft, if prepared from traumatized cartilage (in 19 patients), failed to maintain a stable long-term volume. Partial volume loss was noted in 100% of these patients. However, the rate of this partial resorption was different for every individual and could not be predicted. The highest retention of cartilage graft volume was seen primarily over the nasal osseocartilaginous junction. In nontraumatized patients, however, the engrafted mass maintained long-term volume stability. These patients evidenced no visible external irregularities, and only a few very slight imperfections were noted with finger palpation.
Diced cartilage of traumatic origin is not recommended for any purpose. In such cases, the authors' engrafting algorithm consists of autobone or ear conchal cartilage grafts for dorsal augmentation, columellar struts from the nontraumatized part of the septum, and spreader grafts from the nontraumatized part of the septum or ear concha.
碎软骨移植长期以来一直用于鼻整形手术。尽管有各种报道的优点，但它们也存在一些缺点。植入物不规则的吸收率是碎软骨移植中指出的主要问题之一。尚未阐明吸收率不可预测的原因。本研究旨在确定受创伤软骨与未受创伤软骨作为碎软骨移植来源的作用。
本研究纳入了32例接受使用 Surgicel 包裹的碎软骨移植手术患者的鼻子（19例受创伤的鼻子和13例未受创伤的鼻子）。
本研究中最显著的结果是，如果由受创伤软骨制备（19例患者），Surgicel 包裹的碎软骨移植无法保持稳定的长期体积。这些患者100%出现部分体积丢失。然而，这种部分吸收的速率因人而异，无法预测。软骨移植体积的最高保留主要见于鼻骨软骨交界处。然而，在未受创伤的患者中，植入物保持长期体积稳定。这些患者没有明显的外部不规则，手指触诊仅发现一些非常轻微的瑕疵。
不建议将创伤来源的碎软骨用于任何目的。在这种情况下，作者的植入算法包括用于鼻背增高的自体骨或耳甲软骨移植、来自鼻中隔未受创伤部分的鼻小柱支撑物，以及来自鼻中隔或耳甲未受创伤部分的撑开移植片。
