Department of Otorhinolaryngology, Antalya Finike State Hospital, Finike, Antalya, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Oct;27(5 Suppl):95-100. doi: 10.26355/eurrev_202310_34077.
We reviewed the potential benefits of conchal cartilage or Polydioxanone (PDS) foil-empowered nasal cartilage as caudal septal extension grafts (CSEGs). Research methods included searching online databases such as Google, Google Scholar, PubMed, and Proquest Central at Kırıkkale University. Use terms like "caudal septal extension grafts," "septal extension grafts," "conchal cartilage," and "PDS foil-empowered nasal cartilage" to find related articles. Due to the anchoring of the lower alar cartilage to the nasal septum, the results of a CSEG rhinoplasty are relatively stable over the long term. They can be adjusted independently by the rhinoplasty surgeon. Over time, the skin and soft tissue envelope contract and a downward force for these grafts develops. It allows for independent regulation of projection and rotation, unlike conventional columellar strut procedures and lateral crural steal techniques. Inadequate cartilage may need conchal or costal cartilage, depending on the application and the need for projection and counter rotation. Costal cartilage transplant outperformed conchal cartilage graft in a rabbit model regarding tip projection and angle relapse rate. Three-patient case series show that PDS foil-enhanced nasal cartilage led to septal cartilage loss. However, other research draws a different result, finding that PDS foil-enhanced nasal cartilage prevented growth inhibition in the developing nasal septum following septoplasty, and reduced late problems in animals. The caudal septal extension grafts should prioritize septum cartilage if it is readily available, of adequate size, and with sufficient strength. If this is not possible, PDS foil-enhanced nasal cartilage fragments or conchal cartilage could be used as a backup. PDS foil will maintain the integrity and stability of the implanted cartilage. Due to its strength, stability, and convenient location, conchal cartilage will serve as the second donor site.
我们回顾了耳软骨或聚二氧杂环己酮(PDS)箔增强鼻软骨作为鼻中隔尾侧延伸移植物(CSEG)的潜在益处。研究方法包括在基里卡大学的在线数据库(如 Google、Google Scholar、PubMed 和 ProQuest Central)中搜索,使用“鼻中隔尾侧延伸移植物”、“鼻中隔延伸移植物”、“耳软骨”和“PDS 箔增强鼻软骨”等术语查找相关文章。由于鼻翼软骨的下部附着在鼻中隔上,因此 CSEG 鼻整形术的结果在长期内相对稳定。它们可以由鼻整形外科医生独立调整。随着时间的推移,皮肤和软组织包膜收缩,这些移植物会产生向下的力。这允许独立调节突出度和旋转度,与传统的鼻中隔支柱手术和外侧鼻翼窃血管技术不同。如果需要突出度和反旋转度,软骨不足时可能需要耳软骨或肋软骨。在兔模型中,肋软骨移植在鼻尖突出度和角度复发率方面优于耳软骨移植物。三例患者病例系列研究表明,PDS 箔增强鼻软骨导致鼻中隔软骨丢失。然而,其他研究得出了不同的结果,发现 PDS 箔增强鼻软骨防止了鼻中隔成形术后鼻中隔发育的生长抑制,并减少了动物的晚期问题。如果鼻中隔软骨容易获得、大小合适且具有足够的强度,则鼻中隔尾侧延伸移植物应优先考虑鼻中隔软骨。如果不可能,则可以使用 PDS 箔增强鼻软骨碎片或耳软骨作为备用。PDS 箔将维持植入软骨的完整性和稳定性。由于其强度、稳定性和方便的位置,耳软骨将作为第二个供体部位。