Jang Yong Ju, Kim Do-Youn
Department of Otolaryngology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, The Republic of Korea.
Facial Plast Surg. 2016 Dec;32(6):615-619. doi: 10.1055/s-0036-1594254. Epub 2016 Dec 29.
Revision rhinoplasty in Asian patients is associated with problems related to the use of grafts or implant materials. Moreover, the septal cartilage of Asian individuals is generally weak and small, which makes it particularly vulnerable to injury or secondary deformity during primary surgery. Hence, there is an increased demand for major reconstruction of the septal cartilage framework during revision surgery in Asian patients. In revision rhinoplasty of the nose in Asian patients, appropriate management of the graft or implant is vital. The common problems resulting in the need for revision surgery include displacement, malposition, extrusion, recurrent inflammation, and infection of dorsally implanted alloplastic material. A short-nose deformity following silicone rhinoplasty is also a common problem that is difficult to manage. Furthermore, residual or recurrent deviation of the deviated nose, undercorrection of the convex nasal dorsum, and tip graft-related complications are frequently encountered problems that require revision. In revision rhinoplasty for Asian patients, autologous tissues, such as conchal cartilage and costal cartilage, play a pivotal role for use as a new dorsal implant or building block for major septal reconstruction. Therefore, it is imperative for surgeons to familiarize themselves with the appropriate use of autologous tissues, particularly costal cartilage.
亚洲患者的鼻整形修复手术与使用移植物或植入材料相关的问题有关。此外，亚洲人的鼻中隔软骨通常薄弱且短小，这使得其在初次手术期间特别容易受到损伤或继发畸形。因此，亚洲患者在鼻整形修复手术期间对鼻中隔软骨框架进行重大重建的需求增加。在亚洲患者的鼻整形修复手术中，对移植物或植入物进行适当处理至关重要。导致需要进行修复手术的常见问题包括背侧植入的异体材料移位、位置不当、挤出、反复炎症和感染。硅胶隆鼻术后的短鼻畸形也是一个难以处理的常见问题。此外，偏曲鼻的残留或反复偏曲、鼻背凸度矫正不足以及鼻尖移植物相关并发症是经常遇到的需要修复的问题。在亚洲患者的鼻整形修复手术中，自体组织，如耳甲软骨和肋软骨，作为新的鼻背植入物或用于重大鼻中隔重建的构建块发挥着关键作用。因此，外科医生必须熟悉自体组织的适当使用，尤其是肋软骨。
