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同种异体骨用于鞍鼻畸形重建

Saddle Nose Deformity Reconstruction with a Allograft Bone.

作者信息

Harutyunyan Armen, Hakobyan Gagik

机构信息

Astkhik Medical Center, Department of Oral and Maxillofacial Surgery, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia.

Head of Department of Oral and Maxillofacial Surgery, Yerevan State Medical University, 0028 Kievyan str. 10 ap. 65 c, Yerevan, Armenia.

出版信息

Aesthetic Plast Surg. 2024 Dec;48(23):4839-4847. doi: 10.1007/s00266-024-04123-w. Epub 2024 May 28.

Abstract

OBJECTIVE

Providing lasting cosmetic and functional results for patients with saddle nose deformity with allograft.

METHODS

This report describes experience with using a of freeze-dried allograft bone allograft in 58 patients who underwent dorsal augmentation over 5-year period (2018-2023). Thirty-eight patients had saddle-shaped deformity of the nose, and 16 patients had post-traumatic cases with saddle nose deformities. All patients underwent a clinical examination using computed tomography. Before surgery using a 3D model, the graft was contoured according to the shape of the nasal defect. The grafts were installed using a closed approach and were placed under the periosteum of the bone. Using lateral photographs, anthropometric measurements of the nose were taken before and after surgery to assess aesthetic outcome after surgery. To assess the results of aesthetic rhinoplasty (UQ), the Portuguese version of the Utrecht Questionnaire was used, which contains a visual analogue scale (VAS) on a 5-point Likert scale.

RESULTS

A total of 56 patients were satisfied with the results of the surgical procedure. No complications or major graft resorption was observed. An analysis comparing preoperative and 1-year follow-up data using 3D scanning showed a significant increase in dorsal height without dorsal expansion. After rhinoplasty, the mean visual analog scale (VAS) aesthetic score improved significant from 2.3 preoperatively, 3 months postoperatively 8.4, and 8.9 1 year postoperatively.

CONCLUSION

The use of freeze-dried allograft bone is a useful method of dorsal augmentation in rhinoplasty without donor site complications.

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

目的

使用同种异体移植物为鞍鼻畸形患者提供持久的美容和功能效果。

方法

本报告描述了在5年期间(2018 - 2023年)对58例行鼻背增高术的患者使用冻干同种异体骨移植物的经验。38例患者有鞍状鼻畸形,16例患者有创伤后鞍鼻畸形。所有患者均接受了计算机断层扫描临床检查。在术前使用3D模型,根据鼻缺损的形状对移植物进行塑形。移植物采用闭合入路安装,并置于骨膜下。使用侧面照片,在手术前后对鼻子进行人体测量,以评估术后美学效果。为评估鼻整形术(UQ)的结果,使用了乌得勒支问卷的葡萄牙语版本,其中包含一个5点李克特量表的视觉模拟量表(VAS)。

结果

共有56例患者对手术结果满意。未观察到并发症或明显的移植物吸收。使用3D扫描对术前和1年随访数据进行比较分析显示,鼻背高度显著增加,且无鼻背扩张。鼻整形术后,视觉模拟量表(VAS)美学评分从术前的2.3显著提高到术后3个月的8.4和术后1年的8.9。

结论

使用冻干同种异体骨是鼻整形术中鼻背增高的一种有效方法,且无供区并发症。

证据级别II:本期刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述,请参阅目录或作者在线指南www.springer.com/00266

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