Tehran University of Medical Sciences, Tehran, Iran.
Aesthet Surg J. 2013 Jul;33(5):662-73. doi: 10.1177/1090820X13488133. Epub 2013 May 22.
Correction of cleft lip nasal deformities (CLND) is often unsatisfactory because of problems resulting from cartilage weakness and strong soft tissue forces. Therefore, strong cartilaginous support, such as rib cartilage, is mandatory.
The authors describe placement of rib cartilage grafts to create a more symmetric and aesthetically acceptable repair of CLND with improved nasal air flow.
Two groups of patients, including those with unilateral and bilateral CLND, underwent operations with different sources of autologous cartilage. Group 1 received grafts from the septum and ear, whereas group 2 received grafts from the septum and ribs. Results were evaluated by 2 independent physicians who rated improvement between pre- and postoperative photographs.
There were significant differences in postoperative improvement between patients who received septal/ear cartilage grafts and those who received septal/rib cartilage grafts in both unilateral and bilateral cases (P = .028 and P = .043, respectively).
The authors' results demonstrate that rib cartilage has a positive effect on the aesthetic outcome of CLND operations and provides a strong support structure for correcting this deformity with minimal postoperative complications.
由于软骨薄弱和软组织力量较强导致的问题,唇裂鼻畸形(CLND)的矫正往往不尽如人意。因此,需要强有力的软骨支撑,如肋软骨。
作者描述了肋软骨移植的方法,以创建更对称和更美观的 CLND 修复,并改善鼻通气。
两组唇裂患者,包括单侧和双侧唇裂患者,采用不同来源的自体软骨进行手术。第 1 组接受鼻中隔和耳软骨移植,第 2 组接受鼻中隔和肋软骨移植。由 2 位独立的医生根据术前和术后照片的改善程度进行评估。
在单侧和双侧病例中,接受鼻中隔/耳软骨移植的患者与接受鼻中隔/肋软骨移植的患者在术后改善方面存在显著差异(P =.028 和 P =.043)。
作者的结果表明,肋软骨对 CLND 手术的美学效果有积极影响,并为矫正这种畸形提供了强有力的支撑结构,同时术后并发症最小。