Moon Kyung-Chul, Lee Kyu-Il, Lee Jong-Seok, Kim Ae-Ree, Dhong Eun-Sang, Kim Deok-Woo, Han Seung-Kyu
Department of Plastic Surgery, Korea University Guro Hospital, 148 Gurodong-Gil, Guro-Ku, Seoul, 08308, South Korea.
Department of Pathology, Korea University Guro Hospital, 148 Gurodong-Gil, Guro-Ku, Seoul, 08308, South Korea.
Aesthetic Plast Surg. 2021 Apr;45(2):670-678. doi: 10.1007/s00266-020-01648-8. Epub 2020 Feb 25.
Late-onset inflammation is a rare complication that may occur several months to years after undergoing an uneventful rhinoplasty using alloplastic implants and an uneventful postoperative course. Studies to determine the pathophysiological mechanisms of late-onset inflammation related to implants used in rhinoplasty are limited. The purpose of the study was to analyze differences between non-healthy capsules (NHC) with late-onset inflammation and healthy capsules (HC) without inflammation as controls to determine the possible cause of the inflammation.
Between April 2009 and May 2018, 39 patients who underwent rhinoplasty with alloplastic implants underwent histological studies. Twenty-one patients in the NHC group showed late-onset inflammation, while 18 patients in the HC group did not display late-onset inflammation. Capsules around the alloplastic implants were harvested, and histological studies using hematoxylin and eosin, Masson's trichrome, colloidal iron, and CD31 staining were performed and compared between the NHC and HC groups.
In hematoxylin and eosin and Masson's trichrome staining, edematous granulation tissues, inflammatory cellular contents, and a disorganized collagen layer were increased in the NHC group compared to the HC group. The colloidal iron staining revealed mucin deposition in the NHC group. CD31-positive cells were observed lining the capsule in both groups; however, the lining cells were damaged in the NHC group.
Granulation tissues, inflammatory reaction, collagen degeneration, mucin deposition, and endothelial lining cell damage were greater in the NHC group compared to the HC group. Damaged capsules may play a crucial role in late-onset inflammation.
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迟发性炎症是一种罕见的并发症，可能在使用异体植入物进行隆鼻手术且术后过程顺利数月至数年之后发生。确定与隆鼻术中使用的植入物相关的迟发性炎症病理生理机制的研究有限。本研究的目的是分析有迟发性炎症的非健康包膜（NHC）与作为对照的无炎症的健康包膜（HC）之间的差异，以确定炎症的可能原因。
2009年4月至2018年5月期间，39例行异体植入物隆鼻术的患者接受了组织学研究。NHC组21例患者出现迟发性炎症，而HC组18例患者未出现迟发性炎症。采集异体植入物周围的包膜，进行苏木精-伊红染色、Masson三色染色、胶体铁染色和CD31染色的组织学研究，并在NHC组和HC组之间进行比较。
在苏木精-伊红染色和Masson三色染色中，与HC组相比，NHC组的水肿肉芽组织、炎性细胞成分和紊乱的胶原层增加。胶体铁染色显示NHC组有粘蛋白沉积。两组在包膜内衬均观察到CD31阳性细胞；然而，NHC组的内衬细胞受损。
与HC组相比，NHC组的肉芽组织、炎症反应、胶原变性、粘蛋白沉积和内皮衬里细胞损伤更严重。受损的包膜可能在迟发性炎症中起关键作用。
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