Khan Nazir A, Rehman Ayaz, Yadav Rajshri
Otorhinolaryngology Skims Medical College, Srinagar, India.
Otorhinolaryngology J&K Health Services, Bemina, India.
Indian J Otolaryngol Head Neck Surg. 2016 Sep;68(3):322-8. doi: 10.1007/s12070-016-1007-z. Epub 2016 Jun 27.
The surgeons performing rhinoplasty found Graft selection the greatest challenge. To avoid an immune response the preferred choice thus far for nasal reconstruction would be autograft compared to allograft due to its lower rate of rejection. We have evaluated 30 patients who underwent open rhinoplasty and We used conchal and septal cartilaginous grafts in various forms by the open approach to correct various nasal deformities compared our experience regarding the operative technique, graft availability, indications, and limitations. No bony graft material or synthetic materials were used. Preoperative extensive evaluation of the patient was done in order to determine the type of deformity and the type of graft to be used in order to correct the deformity. Preoperative and postoperative photographs were taken in four basic views: frontal, lateral, lateral-oblique and basal in order to assess the results of the surgery. The study was done on 30 patients (20 male and 10 females) using the external rhinoplasty approach using the septal and conchal cartilages in different forms. Autologous septal cartilage was used in most of the patients (25 out of 30) and conchal cartilage was used in 5 patients. Multiple grafting techniques were used in some patients. Three patients had traumatic etiology. Columellar strut graft along with TIG technique was used in 16 patients, spreader graft was used in 8 patients, and septal extension graft was used in 5 patient and shield graft in 1 patient. Septorhinoplasty continues to evolve through various new techniques and modifications with the main goal to improve functional nasal airway and to restore cosmetic harmony to the face. Optimum result is very much dependent on the surgeon's attention to functional, aesthetic, and reconstructive principles and graft selection.
进行隆鼻手术的外科医生发现移植物的选择是最大的挑战。为避免免疫反应，由于自体移植的排斥率较低，因此迄今为止鼻再造的首选是自体移植而非异体移植。我们评估了30例行开放式隆鼻手术的患者，通过开放式手术使用各种形式的耳甲软骨和鼻中隔软骨移植物来矫正各种鼻畸形，并比较了我们在手术技术、移植物可用性、适应症和局限性方面的经验。未使用骨移植材料或合成材料。对患者进行了术前全面评估，以确定畸形类型以及用于矫正畸形的移植物类型。术前和术后拍摄了四个基本视角的照片：正面、侧面、侧斜位和基底位，以评估手术效果。该研究对30例患者（20例男性和10例女性）采用开放式鼻整形手术方法，使用不同形式的鼻中隔软骨和耳甲软骨。大多数患者（30例中的25例）使用了自体鼻中隔软骨，5例患者使用了耳甲软骨。一些患者采用了多种移植技术。3例患者有外伤病因。16例患者使用了鼻小柱支撑移植物联合鼻翼软骨悬吊技术，8例患者使用了鼻背撑开移植物，5例患者使用了鼻中隔延伸移植物，1例患者使用了盾牌状移植物。鼻整形术通过各种新技术和改良方法不断发展，主要目标是改善鼻腔气道功能并恢复面部的美学和谐。最佳效果很大程度上取决于外科医生对功能、美学和重建原则以及移植物选择的关注。
