Kim Sung Hee, Kim Ji Won, Jang Yong Ju
Department of Otorhinolaryngology-Head and Neck Surgery, National Medical Center, Seoul, Korea.
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Clin Exp Otorhinolaryngol. 2021 Aug;14(3):321-327. doi: 10.21053/ceo.2020.01725. Epub 2020 Dec 18.
When performing cosmetic rhinoplasty with alloplastic materials, complications such as implant visualization, inflammation, dislocation, and extrusion should be thoroughly evaluated. Although computed tomography (CT) can provide useful information about the implant status and its interaction with the skin soft tissue envelope (SSTE), the radiologic findings of these interactions have rarely been reported.
We retrospectively reviewed the data of 80 patients who underwent facial bone CT or ostiomeatal unit CT at Asan Medical Center between July 2008 and January 2020 for the evaluation of dorsal implants with complications. We reviewed the implantation period, implant dislocation, implant curling or deformation, radiodensity (in Hounsfield units), and nasal bone changes including bone erosion or hyperostosis.
Of the 80 patients, 67 (83.8%) had silicone implants and 13 (16.2%) had Gore-Tex implants. The radiologic findings of the silicone implants were as follows: maintenance of the implant shape (80.6%), radiolucency (similar density to that of fat tissue) halo (83.6%), and homogeneous attenuation (82.1%). Peri-implant calcification was often found in silicone implants with >20-year implantation periods. The findings of Gore-Tex were as follows: curling or deformation (84.6%), heterogeneous attenuation (84.6%), and consistent peri-implant calcification over time.
Silicone and Gore-Tex implants have distinctive radiologic features. These findings of alloplastic materials help us to understand how implants behave in the nasal dorsum and how they affect the SSTE.
使用异体材料进行隆鼻整形手术时，应全面评估诸如植入物显影、炎症、移位和挤出等并发症。尽管计算机断层扫描（CT）能够提供有关植入物状态及其与皮肤软组织包膜（SSTE）相互作用的有用信息，但这些相互作用的放射学表现鲜有报道。
我们回顾性分析了2008年7月至2020年1月在峨山医学中心接受面部骨CT或鼻窦CT检查以评估有并发症的鼻背植入物的80例患者的数据。我们评估了植入时间、植入物移位、植入物卷曲或变形、放射密度（亨氏单位）以及鼻骨变化，包括骨质侵蚀或骨质增生。
80例患者中，67例（83.8%）使用硅胶植入物，13例（16.2%）使用戈尔特斯植入物。硅胶植入物的放射学表现如下：植入物形状保持（80.6%）、透亮区（密度与脂肪组织相似）晕圈（83.6%）以及均匀衰减（82.1%）。植入时间超过20年的硅胶植入物常出现植入物周围钙化。戈尔特斯植入物的表现如下：卷曲或变形（84.6%）、不均匀衰减（84.6%）以及随时间植入物周围钙化持续存在。
硅胶和戈尔特斯植入物有独特的放射学特征。这些异体材料的表现有助于我们了解植入物在鼻背的情况以及它们如何影响皮肤软组织包膜。
