Kim Youn Hwan, Kim Jeong Tae
Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, South Korea.
J Craniofac Surg. 2011 Mar;22(2):628-30. doi: 10.1097/SCS.0b013e31820855c1.
For patients with large dorsal defects due to posttraumatic deformities, rib cartilage or calvarial bone is used for reconstruction. Problems such as graft contour, distortion, limited amounts, and donor morbidity continue to exist for cartilage and bone grafts. To overcome the limitations of such grafts, many authors have used diced cartilage wrapped with fascia. However, diced cartilage wrapped with fascia is not suitable for structural support in cases of dorsal nasal collapse. We describe a technique using a dorsal structural graft for a 28-year-old man who had severe dorsal nasal collapse after a traffic collision. For enhancement of strength, we harvested a thick segment of the tensor fascia lata and applied 2 layers. A large amount of rib cartilage was inserted between the thick fascia layers. The tensor fascia lata wrapped with diced cartilage graft for dorsal augmentation is fraught with structural graft, similar to bone or cartilage grafts. This semirigid technique may be another option for dorsal structural support of severe nose deformities.
对于因创伤后畸形导致鼻背大面积缺损的患者，可采用肋软骨或颅骨骨片进行重建。软骨和骨移植仍存在诸如移植体轮廓、变形、数量有限以及供区并发症等问题。为克服此类移植的局限性，许多作者采用了用筋膜包裹的切碎软骨。然而，对于鼻背塌陷的病例，用筋膜包裹的切碎软骨并不适合提供结构支撑。我们描述了一种为一名28岁男性患者使用鼻背结构移植的技术，该患者在交通事故后出现严重的鼻背塌陷。为增强强度，我们切取了一段较厚的阔筋膜张肌并应用了两层。在厚筋膜层之间插入大量肋软骨。用切碎软骨移植包裹阔筋膜张肌用于鼻背增高，与骨或软骨移植一样，存在结构移植的问题。这种半刚性技术可能是严重鼻畸形鼻背结构支撑的另一种选择。
