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应用耳后筋膜瓣(PAFG)在初次和修复性鼻整形术中进行轻度的鼻背增高和不规则的鼻背覆盖:一项前瞻性研究。

The Use of Posterior Auricular Fascia Graft (PAFG) for Slight Dorsal Augmentation and Irregular Dorsum Coverage in Primary and Revision Rhinoplasty: A Prospective Study.

机构信息

Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.

Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy.

出版信息

Aesthetic Plast Surg. 2024 Mar;48(5):862-871. doi: 10.1007/s00266-023-03571-0. Epub 2023 Aug 25.

Abstract

INTRODUCTION

Augmentation and coverage of irregularities of the nasal dorsum remain a challenge in rhinoplasty. Different techniques have been described in the current literature for this purpose. The aim of this study is to assess and illustrate the author experience and outcomes using the posterior auricular fascia graft (PAFG) for dorsal camouflage and augmentation in primary and revision rhinoplasty.

MATERIAL AND METHODS

A prospective bicentric study was conducted, including patients with slight dorsal deficiencies and/or with dorsal irregularities following hump resection, trauma or previous rhinoplasty receiving PAFG to improve the rhinoplasty outcome. To objectively assess the graft resorption rate, MRI was performed 2 weeks and 18 months after surgery. To investigate patient satisfaction, the preoperative and 1-year postoperative scores obtained using the rhinoplasty outcomes evaluation (ROE) scale were compared. The scores following a normal distribution obtained for each patient were compared using a paired t-test.

RESULTS

Forty-five patients were enroled in this study. Average follow-up duration was 35.4 months. Patients' age ranged from 17 to 57 years. No cases of infection or major graft resorption were observed. No postoperative scars were visible at the donor site. All patients were satisfied after surgery, and a statistically significant difference between pre- and postoperative scores (p<0.0001) was observed.

CONCLUSION

This study showed that PAFG is a reliable technique for dorsal camouflage and slight augmentation in primary and revision rhinoplasty. The procedure is safe, easy and quick and only requires a small learning curve.

LEVEL OF EVIDENCE II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

引言

在鼻整形术中,增加和覆盖鼻背的不规则仍然是一个挑战。目前的文献中已经描述了不同的技术用于达到这个目的。本研究旨在评估和展示作者在原发性和修复性鼻整形术中使用耳后筋膜(PAFG)进行鼻背伪装和增强的经验和结果。

材料和方法

进行了一项前瞻性的双中心研究,包括接受 PAFG 以改善鼻整形术结果的轻度鼻背缺陷和/或驼峰切除后、创伤或先前鼻整形术后有鼻背不规则的患者。为了客观评估移植物吸收率,在术后 2 周和 18 个月进行 MRI 检查。为了调查患者满意度,比较了术前和术后 1 年使用鼻整形术结果评估(ROE)量表获得的评分。对于每个患者获得的遵循正态分布的分数,使用配对 t 检验进行比较。

结果

本研究共纳入 45 例患者。平均随访时间为 35.4 个月。患者年龄从 17 岁到 57 岁不等。未观察到感染或主要移植物吸收的病例。供体部位无术后疤痕。所有患者术后均满意,且术前和术后评分之间存在统计学显著差异(p<0.0001)。

结论

本研究表明,PAFG 是原发性和修复性鼻整形术中进行鼻背伪装和轻度增强的可靠技术。该手术安全、简单、快速,只需较小的学习曲线。

证据水平 II:本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南 www.springer.com/00266

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c59/10980619/f870aeb3e7dd/266_2023_3571_Fig1_HTML.jpg

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