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膨体聚四氟乙烯在短鼻延长术中的应用:十四年临床经验

The Use of Expanded Polytetrafluoroethylene in Short Nose Elongation: Fourteen Years of Clinical Experience.

作者信息

Wei Jiao, Herrler Tanja, Deng Ning, Xu Hua, Shi Bowen, Dai Chuanchang

机构信息

Plastic and Reconstructive Surgery and Burn Center, Trauma Center Murnau, Murnau, Germany.

Department of Breast Surgery, LiaoNing Cancer Hospital and Institute, Shenyang.

出版信息

Ann Plast Surg. 2018 Jul;81(1):7-11. doi: 10.1097/SAP.0000000000001481.

Abstract

BACKGROUND

Short nose elongation is a relatively common rhinoplasty procedure, especially in Asia. The selection of the adequate graft material is challenging. Previous reports have described the application of expanded polytetrafluoroethylene (ePTFE) for dorsal augmentation rhinoplasty, but studies using ePTFE for nose elongation are lacking. We propose ePTFE as an alternative treatment for short noses, describe the technique, and discuss outcomes, patient selection, and complications based on our 14-year experience.

METHODS

From February 2003 to December 2016, 206 patients with varying degrees of short noses were included in this retrospective study. All patients underwent nose elongation surgery using an ePTFE implant. Nasal lengths before and after surgery were measured using a 3-dimensional simulation technology. Outcomes and complications including possible underlying reasons were analyzed. Patient satisfaction was evaluated using a self-assessment survey.

RESULTS

Nasal elongation was successfully achieved using ePTFE. Mean increase in nasal length was 4.36 ± 0.85 mm. The mean follow-up period was 13.3 months, ranging from 6 months to 8 years. Follow-up examinations demonstrated stable results. The overall complication rate was 6.8%. Complications included infection, implant extrusion, migration, deviation, visibility, and/or prominence, tissue reaction, and reddening of the nasal skin. Most patients (93.6%) rated their outcome as improved and much improved.

CONCLUSIONS

Nasal elongation using ePTFE implantation is a feasible therapeutic approach for patients with short noses. Reliable outcomes and the absence of donor site morbidity contribute to the high patient acceptance. Meticulous surgical technique and careful patient selection are prerequisites for successful results.

摘要

背景

短鼻延长术是一种相对常见的鼻整形手术,在亚洲尤为如此。选择合适的移植材料具有挑战性。既往报道描述了膨体聚四氟乙烯(ePTFE)在隆鼻术中的应用,但缺乏使用ePTFE进行鼻延长的研究。我们提出将ePTFE作为短鼻的一种替代治疗方法,描述该技术,并根据我们14年的经验讨论治疗效果、患者选择和并发症。

方法

从2003年2月至2016年12月,206例不同程度短鼻患者纳入本回顾性研究。所有患者均使用ePTFE植入物进行鼻延长手术。术前和术后的鼻长度采用三维模拟技术测量。分析治疗效果和并发症,包括可能的潜在原因。采用自我评估调查评估患者满意度。

结果

使用ePTFE成功实现了鼻延长。鼻长度平均增加4.36±0.85mm。平均随访期为13.3个月,范围从6个月至8年。随访检查显示结果稳定。总体并发症发生率为6.8%。并发症包括感染、植入物挤出、移位、偏斜、可见性和/或突出、组织反应以及鼻皮肤发红。大多数患者(93.6%)对其治疗效果评价为改善和明显改善。

结论

对于短鼻患者,使用ePTFE植入进行鼻延长是一种可行的治疗方法。可靠的治疗效果和无供区并发症使得患者接受度较高。精细的手术技术和谨慎的患者选择是取得成功结果的前提条件。

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