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一种改良的将切碎软骨移植物转移至载体材料的抽吸辅助技术及隆鼻术中直接注射未包裹切碎软骨的效果

A Modified Suction-Assisted Technique of Transfer of Diced Cartilage Graft to Carrier Material and Outcome of Direct Injection of Unwrapped Diced Cartilage in Rhinoplasty.

作者信息

Bashir Muhammad Mustehsan, Sohail Muhammad, Khan Farid Ahmad, Jan Sadia Nosheen, Ansari Hamid Hussain, Nazir Umer, Hidayat Zohaib

机构信息

*Plastic, Reconstructive Surgery and Burn Unit, KEMU, Mayo Hospital †Plastic Surgery Department, Shaikh Zayed Medical Complex, Lahore, Pakistan.

出版信息

J Craniofac Surg. 2017 Jun;28(4):924-927. doi: 10.1097/SCS.0000000000003556.

DOI:10.1097/SCS.0000000000003556
PMID:28549044
Abstract

OBJECTIVE

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.

PLACE AND DURATION OF STUDY

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

研究地点和时间

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

方法

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。

结果

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。

结论

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。

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The Treatment of Alar Base Depression in Rhinoplasty with Diced Autologous Cartilage or Mass Cartilage: A Systematic Review.**标题**:自体软骨或大块软骨在鼻整形术中治疗鼻翼基底凹陷的疗效:系统评价 **摘要**:背景:鼻翼基底凹陷会影响鼻下部的外观,可通过手术矫正。目前有多种方法可以治疗鼻翼基底凹陷,其中自体软骨和大块软骨的应用较为广泛。本研究旨在评估在治疗鼻翼基底凹陷的手术中使用自体软骨或大块软骨的效果。 **方法**:我们检索了 Cochrane 图书馆、PubMed、EMBASE 和 Web of Science 核心合集数据库,以获取相关研究。我们对随机对照试验(RCT)和观察性研究进行了筛选,比较了在鼻翼基底凹陷的手术中使用自体软骨或大块软骨与其他方法的效果。 **结果**:共纳入了 11 项研究,包括 7 项 RCT 和 4 项观察性研究。结果显示,在鼻翼基底凹陷的手术中使用自体软骨或大块软骨的治疗效果优于其他方法。 **结论**:自体软骨或大块软骨是治疗鼻翼基底凹陷的有效方法。然而,需要更多高质量的 RCT 来进一步证实这一结论。
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