Oh Jae Hwan, Kim Seon Tae, Jung Joo Hyun, Han Ji Hye, Choi Ji Yun, Kang Il Gyu
Resident, Department of Otolaryngology-Head & Neck Surgery, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
Professor, Department of Otolaryngology-Head & Neck Surgery, Medical Faculty, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
J Oral Maxillofac Surg. 2018 Sep;76(9):1998.e1-1998.e6. doi: 10.1016/j.joms.2018.03.012. Epub 2018 Mar 21.
Tutoplast (Tutogen Medical, Neunkirchen am Brand, Germany)-processed fascia lata (TPFL) has been used for dorsal augmentation in rhinoplasty in the Republic of Korea for approximately 10 years, but few studies have described changes in TPFL in terms of dorsal height over time. We investigated changes in dorsal height after TPFL use as a dorsal implant material during rhinoplasty.
The records of 18 rhinoplasty patients who had undergone dorsal augmentation with TPFL were examined retrospectively. The patients had undergone rhinoplasty from March 2008 to June 2012. Two different ear, nose, and throat doctors analyzed the first follow-up photographs (2 lateral views and 2 oblique views) taken at approximately 1 month postoperatively and the last follow-up photographs taken from 18 to 75 months after surgery. The last follow-up photographs were classified as showing no nasal dorsal height change, slight change, and marked change compared with the first follow-up photographs.
Of the 18 patients enrolled, 50% (n = 9) showed no change in the nasal dorsum whereas 33% (n = 6) showed mild depression and 17% (n = 3) showed marked depression of the nasal dorsum at last follow-up.
About half of the patients who had undergone dorsal augmentation using TPFL during rhinoplasty showed mild or marked dorsal depression over time. It is recommended that TPFL be used with another implant during augmentation rhinoplasty or TPFL be used only for a slightly depressed nose. In addition, patients should be informed that TPFL could be resorbed over time.
在韩国，经Tutoplast（德国纽因基兴的Tutogen Medical公司）处理的阔筋膜（TPFL）已用于鼻整形术中的鼻背增高手术约10年，但很少有研究描述TPFL鼻背高度随时间的变化情况。我们调查了在鼻整形术中将TPFL用作鼻背植入材料后鼻背高度的变化。
回顾性检查了18例行TPFL鼻背增高术的鼻整形患者的记录。这些患者于2008年3月至2012年6月接受了鼻整形术。两名不同的耳鼻喉科医生分析了术后约1个月拍摄的首次随访照片（2张侧视图和2张斜视图）以及术后18至75个月拍摄的末次随访照片。将末次随访照片与首次随访照片相比，分类为鼻背高度无变化、轻微变化和显著变化。
在纳入的18例患者中，50%（n = 9）在末次随访时鼻背无变化，33%（n = 6）表现为鼻背轻度凹陷，17%（n = 3）表现为鼻背显著凹陷。
在鼻整形术中使用TPFL进行鼻背增高的患者中，约一半随着时间推移出现了轻度或显著的鼻背凹陷。建议在隆鼻术中将TPFL与另一种植入物联合使用，或者仅用于鼻背轻度凹陷的情况。此外，应告知患者TPFL可能会随着时间被吸收。
