Bashir Muhammad Mustehsan, Sohail Muhammad, Khan Farid Ahmad, Jan Sadia Nosheen, Ansari Hamid Hussain, Nazir Umer, Hidayat Zohaib
*Plastic, Reconstructive Surgery and Burn Unit, KEMU, Mayo Hospital †Plastic Surgery Department, Shaikh Zayed Medical Complex, Lahore, Pakistan.
J Craniofac Surg. 2017 Jun;28(4):924-927. doi: 10.1097/SCS.0000000000003556.
To describe a modified suction-assisted technique (MSAT) of transfer of diced cartilage (DC) graft to a carrier material and to determine the clinical outcome of direct injection of unwrapped diced cartilage (UDC) in rhinoplasty.
Department of Plastic Surgery, KEMU, Mayo Hospital, Lahore from February 2011 to January 2015 METHODS:: Forty-seven patients of both genders with types 0 to 3 saddle nose deformity were included. Patients with types 4 and 5 saddle nose deformity, diabetes, hypertension, hepatic or renal disorders were excluded. Open tip rhinoplasty was performed in all patients. Eighth and/or ninth costal cartilage was harvested. Cartilage graft was diced into 1 to 2 mm pieces. The DC graft was transferred to carrier material (1-mL syringe) with MSAT. The UDC was then injected into nose and clinical outcome was determined.
Out of 47 patients included in the study 62% were females with mean (standard deviation [SD]) age 22 (4) years. Thirty-four (72%) procedures were primary rhinoplasties while 13 (28%) were secondary rhinoplasties. Mean (SD) carrier material filling time was 12±3 seconds. All operating surgeons involved in study were satisfied with modified suction technique and declared it better than the traditional manual technique of filling the carrier material. Most of the patients were satisfied with their postoperative nasal appearance and complications were minimal. One patient required revision of surgery due to dorsal contour irregularities and another due to partial cartilage absorption at 13 ± 2 months follow-up.
Our MSAT of transfer of DC and injection of UDC is simple, easy to perform, reduces operative time and produces acceptable cosmetic outcome as regard patient's satisfaction.
描述一种将切碎软骨(DC)移植物转移至载体材料的改良抽吸辅助技术(MSAT),并确定在鼻整形术中直接注射未包裹切碎软骨(UDC)的临床效果。
2011年2月至2015年1月,拉合尔梅奥医院卡拉奇真纳医学院整形外科
纳入47例0至3型鞍鼻畸形的男女患者。排除4型和5型鞍鼻畸形、糖尿病、高血压、肝脏或肾脏疾病患者。所有患者均行开放式鼻尖鼻整形术。采集第八和/或第九肋软骨。将软骨移植物切成1至2毫米的小块。采用MSAT将DC移植物转移至载体材料(1毫升注射器)。然后将UDC注入鼻内并确定临床效果。
在纳入研究的47例患者中,62%为女性,平均(标准差[SD])年龄22(4)岁。34例(72%)手术为初次鼻整形术,13例(28%)为二次鼻整形术。载体材料平均填充时间为12±3秒。参与研究的所有手术医生对改良抽吸技术均满意,并宣称其优于传统的手动填充载体材料技术。大多数患者对术后鼻部外观满意,并发症极少。1例患者在13±2个月随访时因鼻背轮廓不规则需要手术修复,另1例因部分软骨吸收需要修复。
我们的DC转移和UDC注射的MSAT简单易行,可减少手术时间,并在患者满意度方面产生可接受的美容效果。