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原发性和继发性鼻中隔成形术中的斜行劈开肋软骨移植手术

Oblique Split Rib Graft Surgery in Primary and Secondary Septorhinoplasty.

作者信息

Loghmani Shahriar, Loghmani Alireza, Maraki Fatemeh

机构信息

Department of Plastic Surgery, Ordibehesht Surgical Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Dentistry, Ordibehesht Surgical Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

World J Plast Surg. 2019 May;8(2):237-244. doi: 10.29252/wjps.8.2.237.

Abstract

BACKGROUND

Rib cartilage is an outstanding material in reconstructive septorhinoplasty, especially in revision surgery with a low rate of complications compared to other materials. In this study, the results of oblique splitting of rib grafts were evaluated in 25 patients operated for primary and secondary septorhinoplasty.

METHODS

The prospective case series were undertaken on 25 patients of saddle or crooked nose that referred to the senior author's private office between January 2015 and November 2017. They had primary and secondary septorhinoplasty using autologous costal cartilage carved by the oblique split method (OSM). The postoperative follow-up period ranged from 3 to 36 months (Mean follow up of 19 months).

RESULTS

The problems seen in patients were saddle-nose deformity in 16 cases, crooked-nose deformity in 3, crooked nose and saddle nose in 3 and implant infection, inverted V-pinch, destruction of septum in 3 more cases. After oblique split rib grafts surgery and 3-36 month follow-up (an average of 19 months), the operative outcomes were successful and no severe resorption, infection, warping or displacement were observed related to graft and patients were also satisfied, and there was no complication of the donor-site. The patients did not have any post-operative complications and no complain of nasal distortion during follow up period.

CONCLUSION

OSM allowed obtaining large quantities of graft material without the risk of warping due to inclusion of both peripheral and central portions of the rib cartilage.

摘要

背景

肋软骨是鼻中隔成形术重建中的一种优秀材料,尤其是在修复手术中,与其他材料相比并发症发生率较低。在本研究中,对25例行一期和二期鼻中隔成形术的患者评估了肋软骨斜劈移植的效果。

方法

对2015年1月至2017年11月间转诊至资深作者私人诊所的25例鞍鼻或歪鼻患者进行了前瞻性病例系列研究。他们接受了使用斜劈法(OSM)雕刻的自体肋软骨进行的一期和二期鼻中隔成形术。术后随访时间为3至36个月(平均随访19个月)。

结果

患者出现的问题包括16例鞍鼻畸形、3例歪鼻畸形、3例歪鼻合并鞍鼻畸形,另外3例出现植入物感染、倒V形挛缩、鼻中隔破坏。在斜劈肋软骨移植手术后并经过3至36个月(平均19个月)的随访,手术结果成功,未观察到与移植相关的严重吸收、感染、翘曲或移位,患者也感到满意,供区无并发症。患者术后无任何并发症,随访期间无鼻畸形主诉。

结论

斜劈法能够获取大量移植材料,且由于包含了肋软骨的外周和中央部分而不存在翘曲风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9b3/6620820/1b6ad2251f3b/wjps-8-237-g001.jpg

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