Berghaus A, San Nicoló M, Jacobi C
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Grosshadern Campus Ludwig-Maximilian-University Munich, Marchioninistr. 15, 81377, Munich, Germany.
HNO. 2018 Feb;66(2):103-110. doi: 10.1007/s00106-017-0414-0.
Although several methods have been described to address nasal dorsum augmentation and smoothing of irregularities in rhinoplasty, establishing the ideal method has proven controversial.
Here, we introduce a novel technique of cartilage grafting for nasal dorsum augmentation by wrapping cartilage in a fibrinogen- and thrombin-coated collagen patch called TachoSil®.
In a pilot study comprising ten cases, the use of the collagen patch was examined in various indications in rhinoplasty. Patients were clinically monitored for up to 8 months and photometric and sonographic documentation was performed pre- and postoperatively.
In nine patients, the collagen patch was used for fixation of cartilage grafts in different indications: saddle nose deformities (n = 5), open roof (n = 1), nasal dorsum irregularities (n = 3). A diced cartilage graft enclosed by a bilayer of TachoSil® was applied in seven patients. Solid pieces of cartilage were either embedded in a bilayer of the collagen patch (n = 1) or covered by a monolayer (n = 1). Moreover, the collagen patch alone served as a soft tissue support in one patient with thin skin. Six patients were revision cases. All patients had uneventful healing without adverse events such as allergic reactions and infections.
The collagen patch TachoSil® is eligible for various indications in rhinoplasty. It is a useful material predominantly for nasal dorsum augmentation by sandwiching diced or solid cartilage in the collagen patch, leading to better graft fixation and precise profile shaping. At the same time, TachoSil® helps with blood control. Follow-up studies will be performed to assess the material's long-term behavior.
尽管已有多种方法用于鼻整形术中鼻背增高及不平整修复，但确定理想方法仍存在争议。
在此，我们介绍一种新型软骨移植技术，通过将软骨包裹在一种名为TachoSil®的纤维蛋白原和凝血酶包被的胶原补片中进行鼻背增高。
在一项包含10例患者的初步研究中，对胶原补片在鼻整形术的各种适应证中的应用进行了研究。对患者进行了长达8个月的临床监测，并在术前和术后进行了光度测量和超声记录。
9例患者中，胶原补片用于不同适应证的软骨移植固定：鞍鼻畸形（n = 5）、开放性鼻顶（n = 1）、鼻背不平整（n = 3）。7例患者应用了由双层TachoSil®包裹的切碎软骨移植。整块软骨要么嵌入胶原补片双层中（n = 1），要么被单层覆盖（n = 1）。此外，胶原补片单独用作1例皮肤薄的患者的软组织支撑。6例患者为翻修病例。所有患者愈合顺利，未发生过敏反应和感染等不良事件。
胶原补片TachoSil®适用于鼻整形术的各种适应证。它是一种有用的材料，主要用于通过将切碎或整块软骨夹在胶原补片中进行鼻背增高，从而实现更好的移植固定和精确的轮廓塑形。同时，TachoSil®有助于控制出血。将进行随访研究以评估该材料的长期性能。
