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软骨膜移植:鼻外科手术中的获取方法及适应证

Perichondrium graft: harvesting and indications in nasal surgery.

作者信息

Boccieri Armando, Marianetti Tito M

机构信息

Department of Maxillofacial Surgery, San Camillo Hospital, Rome, Italy.

出版信息

J Craniofac Surg. 2010 Jan;21(1):40-4. doi: 10.1097/SCS.0b013e3181c362df.

Abstract

Irregularities in the nasal contour of patients who underwent multiple surgeries are frequently related also by skilled surgeons. The aim of this study was to describe the method of harvesting and the primary applications of erichondrium grafts in revision rhinoplasty to prevent postoperative irregularities.Conchal grafts were used in the reconstruction of structures missing as a result of rhinoplasty. The perichondrium was removed from the cartilage during harvesting and fixed on the cartilagenous grafts to fill up empty spaces and make uniform the surface of the grafts. These techniques were used on 62 patients.All of the patients treated showed aesthetic improvement with respect to the preoperative situation. Comparison with other cases in which the perichondrium graft was not used demonstrates its effectiveness in avoiding certain sequelae over time, especially as regards the presence of unattractive sharp edges often visible beneath the cutaneous covering after the use of structural grafts.In conclusion, perichondrium grafting during secondary rhinoplasty is an easily performed technique that involves a small increase in operating time if combined with the harvesting of conchal material. Its application over the surface of cartilage grafts constitutes a stable covering over time that protects the definitive result from irregularities caused by the disappearance of postoperative edema and scar retraction.

摘要

接受过多次手术的患者鼻轮廓不规则,即使是技术娴熟的外科医生也常常会遇到。本研究的目的是描述耳软骨移植在鼻整形修复术中的获取方法及主要应用,以防止术后出现不规则情况。耳甲腔移植用于修复因鼻整形导致缺失的结构。获取过程中,将软骨膜从软骨上取下并固定在软骨移植片上,以填充空隙并使移植片表面均匀。这些技术应用于62例患者。所有接受治疗的患者与术前相比均有美学改善。与未使用软骨膜移植的其他病例相比,表明随着时间推移其在避免某些后遗症方面的有效性,尤其是在使用结构移植片后,皮肤覆盖下常可见到不美观的锐利边缘。总之,二次鼻整形术中的软骨膜移植是一种操作简便的技术,如果与耳甲腔材料获取相结合,手术时间只会稍有增加。其在软骨移植片表面的应用随着时间推移构成了一个稳定的覆盖层,可保护最终效果免受术后水肿消失和瘢痕收缩导致的不规则影响。

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