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使用折叠多孔聚乙烯植入物进行中隔重建:一种用于矫正亚洲人群重度鞍鼻畸形的替代技术。

Septal Reconstruction With Folded Porous Polythylene Implants: An Alternative Technique for the Correction of Severe Saddle Nose Deformities in Asian Populations.

机构信息

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.

出版信息

J Craniofac Surg. 2021 Jun 1;32(4):1325-1330. doi: 10.1097/SCS.0000000000007260.

Abstract

BACKGROUND

Congenital or secondary deficiency in septal cartilage leads to an unpleasant cosmetic appearance and compromised function as well. Rhinoplasty maneuvers such as spreader graft and septal extension graft with autologous tissue have been exhibited to correct the deformities. However, the relatively severe donor site morbidity stands as a main concern for both surgeons and patients.

METHODS

From January of 2014 to April of 2018, 52 patients presenting septal deformities underwent rhinoplasty with our modified technique. A piece of Medpor (8438) was tailored, folded and then placed as a combination of spreader and septal extension graft. The surgical outcomes were evaluated both objectively and subjectively.

RESULTS

All the patients were followed up for 12 to 24 months postoperatively. The ratio of tip projection and the nasal length exhibited significant improvement in all our patients. Nasal obstruction subjectively mended among the 24 patients who had airway obstruction complaint preoperatively. Only 2 patients had severe adverse events and the implants were removed instantly.

CONCLUSIONS

With our modified technique, Medpor proved to be an effective and reliable material for the reconstruction of septal cartilage, which provides us an alternative way to achieve extended spreader and septal extension graft with one single implant in the correction of saddle nose.Level of Evidence: Level IV, therapeutic study.

摘要

背景

鼻中隔软骨的先天或后天缺陷会导致不美观的外观和功能受损。鼻整形术的操作,如鼻中隔延伸移植物和自体组织的鼻中隔撑开移植物,已被证明可以矫正畸形。然而,相对严重的供区并发症仍然是外科医生和患者关注的主要问题。

方法

从 2014 年 1 月到 2018 年 4 月,52 名鼻中隔畸形患者接受了我们改良技术的鼻整形术。一块 Medpor(8438)被裁剪、折叠,然后作为鼻中隔撑开移植物和鼻中隔延伸移植物的组合放置。客观和主观评估手术结果。

结果

所有患者均在术后 12-24 个月进行随访。所有患者的鼻尖突出度和鼻长比例均有显著改善。术前有气道阻塞症状的 24 例患者中,主观上鼻阻塞得到改善。只有 2 例患者发生严重不良事件,植入物立即取出。

结论

我们的改良技术中,Medpor 被证明是重建鼻中隔软骨的有效和可靠的材料,为我们提供了一种替代方法,即用一个单一的植入物来实现扩展的鼻中隔撑开移植物和鼻中隔延伸移植物,从而在矫正鞍鼻畸形时。

证据等级

IV 级,治疗研究。

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