Yoo Shin Hyuk, Kim Don-Han, Jang Yong Ju
From the Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine; and Department of Digital Content, University of Ulsan.
Plast Reconstr Surg. 2022 Oct 1;150(4):757e-766e. doi: 10.1097/PRS.0000000000009568. Epub 2022 Jul 26.
In dorsal augmentation, costal cartilage can be used in a number of different ways: monobloc, fascia wrapped, or glued diced cartilage grafting (GDCG). The authors developed a mold to make the use of GDCG more convenient. This report describes their experience with GDCG using a novel mold for dorsal augmentation.
The study involved 80 patients who underwent dorsal augmentation with the molded GDCG. Facial photographs and medical records were reviewed to assess patient satisfaction and postoperative complications. For the 23 patients who had three-dimensional scanned imaging, dorsal widths and dorsal heights at the radix and rhinion levels were measured to investigate changes in the implants over time. Resorption of the graft was assessed comparing the 3-month postoperative photograph with the latest photograph taken at the last follow-up (at least 1 year after the surgery). Serial changes of the dorsum were assessed with three-dimensional scanned images.
A total of 66 patients (82.5 percent) were satisfied with their surgical outcomes. Complications were encountered in 19 patients (23.8 percent) and eight revision procedures (10 percent) were performed. One patient underwent revision surgery because of resorption of the GDCG. Analysis using a three-dimensional scanning device showed a significant increment of the dorsal height ( p < 0.05) without dorsal widening when comparing preoperative with 1-year postoperative follow-up data. There were no significant reductions in dorsal height between postoperative 3 months and 1 year.
The use of a novel mold for shaping glued diced cartilage appears to be a useful technique for dorsal augmentation in rhinoplasty.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
在鼻背增高术中，肋软骨有多种不同的使用方式：整块使用、用筋膜包裹或采用粘贴式碎软骨移植术（GDCG）。作者研发了一种模具，以使GDCG的使用更加便捷。本报告描述了他们使用新型模具进行GDCG鼻背增高术的经验。
该研究纳入了80例行模具成型GDCG鼻背增高术的患者。回顾面部照片和病历以评估患者满意度和术后并发症。对23例行三维扫描成像的患者，测量鼻根和鼻骨水平的鼻背宽度和高度，以研究植入物随时间的变化。通过比较术后3个月照片与最后一次随访（至少术后1年）拍摄的最新照片来评估移植物的吸收情况。利用三维扫描图像评估鼻背的连续变化。
共有66例患者（82.5%）对手术效果满意。19例患者（23.8%）出现并发症，其中8例（10%）进行了修复手术。1例患者因GDCG吸收而接受了修复手术。使用三维扫描设备分析显示，与术前相比，术后1年随访数据显示鼻背高度显著增加（p<0.05），且鼻背未变宽。术后3个月至1年期间，鼻背高度无显著降低。
使用新型模具塑造粘贴式碎软骨似乎是鼻整形术中鼻背增高的一种有用技术。
临床问题/证据水平：治疗性，IV级。
