Turegun Murat, Acarturk Tahsin Oguz, Ozturk Serdar, Sengezer Mustafa
Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy, Etlik, Ankara, Turkey.
Ann Plast Surg. 2008 Jun;60(6):600-3. doi: 10.1097/SAP.0b013e3181344453.
Functional disorders due to alar valve collapse and cosmetic unsatisfactory results can be seen after rhinoplasty operation in some patients. Because of overresection of the upper and lower lateral cartilages, nasal lateral walls may collapse during inspiration pressing against the septum and obstructing airway. On the other hand, overresection may result in several cosmetic deformities. Fourteen patients presenting with nasal deformation and functional insufficiency, were treated using thin sheet porous polyethylene (Medpor). Cottle sign was positive in all patients. On examination, collapse during inspiration, depression at the supratip area, and asymmetry were common findings. Saddle shaped implants, 1.2 x 40 mm in dimension, were introduced into pouches prepared via bilateral rim incision. After suturing incisions, bandage and cast were applied. In the mean 14-month follow-up period, 1 implant malposition was seen in a patient because of larger planning the pocket that was corrected by a subsequent shaving of the implant. Asymmetries of the noses were totally corrected. No exposition was found. Alar collapse and respiration impairment had disappeared in all patients. Although, autologous tissue is known as the best material, Medpor can be used safely regarding its low complication rate because of its porotic architecture and low morbidity in donors. Medpor implant provides functional improvement by its strength body. Its smooth surface helps to correct the asymmetry by filling the defects. Using a saddle shape enabled us to treat different components of the postrhinoplasty deformity with a single implant.
在一些患者的隆鼻手术后，可出现由于鼻翼瓣塌陷导致的功能障碍和美容效果不理想的情况。由于上、下外侧软骨切除过多，鼻侧壁在吸气时可能会塌陷，压迫鼻中隔并阻塞气道。另一方面，过度切除可能会导致多种美容畸形。14例出现鼻畸形和功能不全的患者使用了薄片多孔聚乙烯（Medpor）进行治疗。所有患者的科特尔征均为阳性。检查时，吸气时塌陷、鼻尖上区凹陷和不对称是常见表现。将尺寸为1.2×40mm的鞍形植入物植入通过双侧边缘切口制备的袋囊中。缝合切口后，进行包扎和打石膏。在平均14个月的随访期内，1例患者因袋囊规划过大出现植入物位置不当，随后通过对植入物进行修整得以纠正。鼻部不对称完全得到矫正。未发现外露情况。所有患者的鼻翼塌陷和呼吸障碍均已消失。虽然自体组织被认为是最佳材料，但Medpor因其多孔结构和供体发病率低，并发症发生率低，可安全使用。Medpor植入物凭借其坚固的主体结构改善功能。其光滑的表面有助于通过填充缺损来矫正不对称。使用鞍形使我们能够用单个植入物治疗隆鼻术后畸形的不同部分。
