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膨体聚四氟乙烯联合人脱细胞真皮基质用于术后畸形患者的鼻再造

Expanded Polytetrafluoroethylene Combined with Human Acellular Dermis Matrix for the Nasal Reconstruction in Patients with Postoperative Deformities.

作者信息

Tuan Hoang Thanh, Ai Luu Dang, Ngoc Nguyen Anh, Huong Nguyen Thi Lan, Vinh Vu Quang, Van Anh Tran

机构信息

Plastic and Reconstructive Aesthetic Surgery Center, Vietnam National Burn Hospital, Military Medical University, Hanoi, Vietnam.

Hoang Tuan Clinic, Hoang Quoc Viet, Hanoi, Vietnam.

出版信息

Aesthetic Plast Surg. 2025 Feb;49(3):683-689. doi: 10.1007/s00266-024-04277-7. Epub 2024 Aug 5.

Abstract

INTRODUCTION

Augmentation rhinoplasty is one of five aesthetic surgeries in the world. Expanded polytetrafluoroethylene (ePTFE) has been reported as a rational choice to augment the nasal dorsum and tip. However, its application for nasal tip augmentation has some debates. This study presented a technique using ePTFE grafts combined with human acellular dermis matrix (HADM) to reconstruct a deformed nose caused by previous rhinoplasties.

METHODS

50 female patients who came to the hospital from 08/2022 to 09/2022 for surgical revision of their nasal deformity. ePTFE was applied to reconstruct the nasal dorsum, tip, and columella strut. HADM grafts were utilized to reinforce the reconstructed framework. Patients were evaluated for at least 12 months for both aesthetic and functional results.

RESULTS

Postoperatively, the nasal dorsal length increased from 38.9 ± 1.32 to 43.4 ± 1.22 mm; while, the projection of the nasal tip also raised from 19.8 ± 1.16 to 23.9 ± 1.05 mm. 38 patients (76%) reported that their breathing and smelling were improved compared to preoperatively. No cases had implant reactions, extrusion, or warping columella strut. Most of the patients (84%) were satisfied with the surgical outcomes. Three patients (6%) had redness at the nasal tip. The nasal tip of ten patients (20%) was hardened for 3 months postoperatively. There were 6% of patients who developed an infection and 2% of patients had asymmetric soft tissues of the tip 3 postoperative months.

CONCLUSION

This technique brought satisfactory aesthetic and functional results to patients, with no extrusion or rejection observed 12 months postoperatively. Infection was a prominent complication that should be considered and strictly monitored.

LEVEL OF EVIDENCE III

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 Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

引言

隆鼻术是全球五大美容手术之一。膨体聚四氟乙烯(ePTFE)已被报道为隆鼻背和鼻尖的合理选择。然而,其在鼻尖整形中的应用存在一些争议。本研究介绍了一种使用ePTFE移植物结合人脱细胞真皮基质(HADM)来修复因先前隆鼻手术导致的鼻畸形的技术。

方法

2022年8月至2022年9月期间,50名女性患者因鼻畸形手术修复前来本院。应用ePTFE修复鼻背、鼻尖和鼻小柱支撑。使用HADM移植物加固重建框架。对患者进行至少12个月的美学和功能结果评估。

结果

术后,鼻背长度从38.9±1.32毫米增加到43.4±1.22毫米;同时,鼻尖突出度也从19.8±1.16毫米提高到23.9±1.05毫米。38名患者(76%)报告称与术前相比,呼吸和嗅觉有所改善。没有病例出现植入物反应、挤出或鼻小柱支撑弯曲。大多数患者(84%)对手术结果满意。3名患者(6%)鼻尖发红。10名患者(20%)的鼻尖在术后3个月变硬。6%的患者发生感染,2%的患者在术后3个月鼻尖软组织不对称。

结论

该技术为患者带来了满意的美学和功能结果,术后12个月未观察到挤出或排斥反应。感染是一个突出的并发症,应予以考虑并严格监测。

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

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