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隆鼻术和鼻重建术后软骨移植供区并发症

Cartilage Graft Donor Site Morbidity following Rhinoplasty and Nasal Reconstruction.

作者信息

Ho Thuy-Van Tina, Sykes Kevin, Kriet J David, Humphrey Clinton

机构信息

Department of Otolaryngology, University of Kansas Medical Center, Kansas City, Kansas.

出版信息

Craniomaxillofac Trauma Reconstr. 2018 Dec;11(4):278-284. doi: 10.1055/s-0037-1607065. Epub 2017 Oct 25.

Abstract

Although surgical techniques for rhinoplasty and nasal reconstruction are well established, prospective research on postoperative morbidity remains limited. The aim of this pilot study was to assess costal and auricular cartilage donor site pain and morbidity in patients undergoing rhinoplasty and nasal reconstruction. In this prospective cohort study, we enrolled 55 patients undergoing nasal surgery that required costal or auricular cartilage harvest from February 2015 through May 2016. Each patient was given a symptom-specific patient survey that assessed general pain, nasal pain, graft donor site pain, graft donor site itching, color variation, skin stiffness and thickness, and graft donor site appearance at 1, 4, and 12 weeks after surgery. Our patient group was 55% female (  = 30); the mean age was 47 years. Rib cartilage graft patients had significantly greater nasal pain than cartilage donor site pain. There was no significant difference in rib versus ear cartilage donor site pain. Nearly all patients reported that they were not at all concerned about their scar appearance or ear shape and appearance. No prior studies compare cartilage donor site morbidity in patients undergoing nasal surgery. Our findings challenge the conventional wisdom that utilizing auricular and costal cartilage results in high levels of donor site pain. Surgeons should have a low threshold to harvest rib or ear cartilage when it can improve surgical outcome.

摘要

尽管隆鼻术和鼻再造术的外科技术已相当成熟,但关于术后发病率的前瞻性研究仍然有限。这项初步研究的目的是评估接受隆鼻术和鼻再造术患者的肋软骨和耳软骨供体部位的疼痛及发病率。在这项前瞻性队列研究中,我们纳入了2015年2月至2016年5月期间接受需要采集肋软骨或耳软骨的鼻部手术的55例患者。每位患者在术后1周、4周和12周时都接受了一份针对特定症状的患者调查问卷,该问卷评估了一般疼痛、鼻部疼痛、移植物供体部位疼痛、移植物供体部位瘙痒、颜色变化、皮肤硬度和厚度以及移植物供体部位外观。我们的患者组中女性占55%(n = 30);平均年龄为47岁。肋软骨移植患者的鼻部疼痛明显大于软骨供体部位疼痛。肋软骨供体部位疼痛与耳软骨供体部位疼痛之间没有显著差异。几乎所有患者都表示他们一点也不担心自己的疤痕外观或耳朵形状及外观。此前没有研究比较接受鼻部手术患者的软骨供体部位发病率。我们的研究结果挑战了传统观念,即使用耳软骨和肋软骨会导致供体部位疼痛程度较高。当肋软骨或耳软骨能够改善手术效果时,外科医生应降低采集的门槛。

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