School of Medicine, 6650Ponce Health Sciences University, Ponce, PR, USA.
Department of Plastic & Reconstructive Surgery, 21638University of Kansas Medical Center, Kansas City, KS, USA.
Cleft Palate Craniofac J. 2021 Aug;58(8):974-983. doi: 10.1177/1055665620980228. Epub 2020 Dec 28.
To compare cartilage grafting outcomes in intermediate versus definitive cleft rhinoplasty.
A retrospective chart review was conducted. The χ and Fisher exact tests were used for statistical analyses. Results were considered statistically significant at < .05.
All subjects who underwent revision cleft rhinoplasties between July 2011 and June 2019 were included. Subjects with syndromic conditions were excluded.
A total of 46 subjects with a cleft nose deformity underwent 65 rhinoplasty procedures. The ages averaged 17 years (range 5-50) with 34 (73.9%) males and 12 (26.1%) females. In the intermediate group, 6 (28.6%) subjects required cartilage grafting as part of 6 cleft rhinoplasties, whereas 15 (71.4%) subjects underwent a total of 26 cleft rhinoplasties that did not require grafting. In the definitive group, 18 (76%) subjects required cartilage grafting over 21 cleft rhinoplasties, whereas 7 (24%) subjects underwent a total of 9 cleft rhinoplasties where cartilage grafting was not required. The difference between the number of subjects requiring cartilage grafting in the intermediate versus the definitive group was statistically significant ( = .007). Ear concha and nose were the most frequently used cartilage donor sites, with no observed complications.
Cartilage grafting was significantly more common in the definitive rhinoplasty group. Intermediate cleft rhinoplasty during the 5- to 13-year age period was effective, with a low-risk profile. In our experience, ear concha and nose were the preferred cartilage donor sites, with effective results and an excellent safety profile.
比较中期与确定性唇裂鼻整形术的软骨移植效果。
回顾性图表分析。采用卡方和 Fisher 精确检验进行统计学分析。结果以 P ＜0.05 认为具有统计学意义。
所有接受过 2011 年 7 月至 2019 年 6 月间修复性唇裂鼻整形术的患者均被纳入研究。患有综合征的患者被排除在外。
共有 46 名存在唇裂鼻畸形的患者接受了 65 次鼻整形术。患者平均年龄 17 岁（5-50 岁），其中 34 名（73.9%）为男性，12 名（26.1%）为女性。在中期组中，6 名（28.6%）患者需要软骨移植作为 6 次唇裂鼻整形术的一部分，而 15 名（71.4%）患者总共进行了 26 次无需移植的唇裂鼻整形术。在确定性组中，18 名（76%）患者在 21 次唇裂鼻整形术中需要软骨移植，而 7 名（24%）患者总共进行了 9 次无需软骨移植的唇裂鼻整形术。中期与确定性组间需要软骨移植的患者数量存在显著差异（=0.007）。耳软骨和鼻软骨是最常使用的软骨供区，未观察到并发症。
确定性鼻整形术中软骨移植更为常见。5-13 岁期间的中期唇裂鼻整形术是有效的，具有低风险特征。根据我们的经验，耳软骨和鼻软骨是首选的软骨供区，效果显著，安全性良好。
