Chen Hui, Wang Xiancheng, Deng Yiwen
Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Aesthetic Plast Surg. 2023 Feb;47(1):304-312. doi: 10.1007/s00266-022-03075-3. Epub 2022 Sep 7.
To estimate the complications using autologous costal cartilage as grafts in rhinoplasty objectively and systematically with newly published literature.
The literature was searched systematically; included studies were published between July of 1990 and April of 2020. Meta-analysis was performed using a random-effects model.
Twenty studies involving 1648 patients were included for meta-analysis. The pooled rates of complications were 3.05% of warping (95% CI 1.36-5.19%), 1.2% of resorption (95% CI 0.26-2.56%), 1.45% of infection (95% CI 0.34-3.06%), and 1.53% of contour irregularity (95% CI 0.53-2.88%). The revision rate was 2.25% (95% CI 0.96-3.9%). Regarding of donor-site morbidities, the rate of hypertrophic chest scar was 2.08% (95% CI 0.31-4.83%), and the rate of pneumothorax was 0% (95% CI 0-0.46%). The pooled rates of complications were 9.06% (95% CI 6.13-12.43%) at the recipient site when complications at the recipient site did not include revision surgery, 1.47% (95% CI 0.17-3.56%) at the donor site, and 15.13% (95%CI 11.03-19.69%) overall. The recipient-site adverse event rate was 12.44% (95% CI 8.98-16.33%).
Warping was found the most common complication after rhinoplasty with autologous costal cartilage. Revision after rhinoplasty using autologous costal cartilage was increased in these years. Donor-site complications increased the complication rate after rhinoplasty using autologous rib cartilage by 22%.
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利用新发表的文献客观、系统地评估自体肋软骨用于鼻整形术中的并发症。
系统检索文献；纳入的研究发表于1990年7月至2020年4月之间。采用随机效应模型进行荟萃分析。
纳入20项研究，共1648例患者进行荟萃分析。并发症的合并发生率为：弯曲3.05%（95%CI 1.36 - 5.19%）、吸收1.2%（95%CI 0.26 - 2.56%）、感染1.45%（95%CI 0.34 - 3.06%）、外形不规则1.53%（95%CI 0.53 - 2.88%）。修复率为2.25%（95%CI 0.96 - 3.9%）。关于供区并发症，肥厚性胸部瘢痕发生率为2.08%（95%CI 0.31 - 4.83%），气胸发生率为0%（95%CI 0 - 0.46%）。当受区并发症不包括修复手术时，受区并发症的合并发生率为9.06%（95%CI 6.13 - 12.43%），供区为1.47%（95%CI 0.17 - 3.56%），总体为15.13%（95%CI 11.03 - 19.69%）。受区不良事件发生率为12.44%（95%CI 8.98 - 16.33%）。
自体肋软骨鼻整形术后弯曲是最常见的并发症。近年来，自体肋软骨鼻整形术后的修复率有所增加。供区并发症使自体肋软骨鼻整形术后的并发症发生率增加了22%。
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