Otolaryngology Department, Tanta University, Tanta, Egypt.
Otolaryngology Department, Tanta University, Tanta, Egypt.
Int J Oral Maxillofac Surg. 2019 Dec;48(12):1552-1557. doi: 10.1016/j.ijom.2019.03.004. Epub 2019 Mar 28.
Irregularities of the nasal dorsum after rhinoplasty are frustrating for the patient and the surgeon. Different grafts and implants have been adopted to camouflage this nasal imperfection. This study was performed to assess the outcome of a composite chondrofascial 'cigar' graft for contouring an irregular nasal dorsum. Thirty-six patients who underwent rhinoplasty between May 2014 and October 2016 were studied prospectively. The cartilaginous core of the graft was obtained from the septal or conchal cartilage, while the graft outer sleeve was harvested from the right lateral thigh fascia lata. The graft was secured over the nasal dorsum through an external rhinoplasty approach. The patients were followed up for at least 18 months postoperative. All participants were evaluated objectively by two independent rhinoplasty surgeons and subjectively by Rhinoplasty Outcome Evaluation (ROE) score. Donor site morbidity was also assessed. All patients had satisfactory aesthetic results with no apparent irregularities detected over the nasal dorsum. The ROE score improved, from a mean of 20.94±8.67 (range 8-58) preoperatively to a mean of 79.56±10.65 (range 50-96) postoperatively. Insignificant donor site morbidity was encountered, with inconsequential effects. The chondrofascial cigar graft is a reliable method for contouring dorsal irregularities, particularly in patients with thin nasal skin.
隆鼻术后出现的鼻背畸形会令患者和外科医生感到沮丧。为了掩饰这种鼻畸形，人们采用了不同的移植物和植入物。本研究旨在评估复合软骨筋膜“雪茄”移植物在矫正不规则鼻背中的效果。
2014 年 5 月至 2016 年 10 月期间，前瞻性研究了 36 例行隆鼻术的患者。移植物的软骨核心取自鼻中隔或耳软骨，而移植物的外套管则取自右侧大腿阔筋膜。通过外鼻整形术将移植物固定在鼻背上方。术后至少随访 18 个月。所有患者均由两名独立的鼻整形术外科医生进行客观评估，并通过 Rhinoplasty Outcome Evaluation（ROE）评分进行主观评估。还评估了供区的并发症。
所有患者的美学效果均令人满意，鼻背未发现明显畸形。ROE 评分从术前的平均 20.94±8.67（范围 8-58）改善至术后的平均 79.56±10.65（范围 50-96）。供区并发症轻微，影响不大。
软骨筋膜雪茄移植物是矫正背部畸形的可靠方法，尤其适用于鼻皮肤较薄的患者。
