Department of Otorhinolaryngology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; Department of Otorhinolaryngology and Maxillofacial Surgery, Hospital Franz Tappeiner, Meran/Merano, South Tyrol, Italy.
Department of Plastic Surgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
J Plast Reconstr Aesthet Surg. 2024 Oct;97:115-123. doi: 10.1016/j.bjps.2024.07.045. Epub 2024 Jul 29.
Diced cartilage (DC) plays an integral role in rhinoplasty, and its application is well established in nasal dorsal augmentation rhinoplasty as a diced cartilage framework (DCF).
Fifteen patients requiring nasal dorsal augmentation were included. Two different types of DCF were applied: DC wrapped in fascia lata or Lyomesh® and DC embedded in platelet-rich fibrin (PRF). Postoperative ultrasound follow-ups were performed at intervals of one month, three months, and one year after surgery using a high-frequency linear ultrasound transducer. The aim was to depict the viability of the DCF in vivo.
DCF was successfully depicted using ultrasound imaging in all 15 patients. Ultrasound rendered DC as hypoechoic and inhomogeneous areas. Perifocal hypoechoic edema was detected, which significantly decreased by the one-year follow-up. During the one-year postoperative period, very little DC had decreased in diameter and the framework was fully intact, with no signs of migration. On high-frequency ultrasound, DC wrapped in fascia lata or Lyomesh® appeared as a hypoechoic and inhomogeneous area clearly limited by a thin hyperechoic envelope material, whereas DC embedded in PRF presented as a hypoechogenic area that spread laterally along the bone and nasal cartilage on both sides. Using color Doppler imaging, neovascularization of the DCF was identified in 7 of 15 patients at the postoperative examination.
High-resolution ultrasound is an accurate, non-invasive imaging method appropriate for visualizing DCF in augmentation rhinoplasty. Additionally, it is possible to detect nascent neovascularization within grafts by using color Doppler imaging.
碎软骨（DC）在鼻整形术中起着重要作用，其作为一种碎软骨框架（DCF）在鼻背增高鼻整形术中的应用已得到充分证实。
纳入 15 例需要鼻背增高的患者。应用两种不同类型的 DCF：包裹在阔筋膜或 Lyomesh®中的 DC 或嵌入富含血小板纤维蛋白（PRF）中的 DC。术后一个月、三个月和一年分别使用高频线性超声探头进行术后超声随访，以描绘 DCF 在体内的活力。
15 例患者的 DCF 均成功通过超声成像显示。超声显示 DC 为低回声且不均匀区域。检测到周围低回声水肿，在一年随访时显著减少。在术后一年期间，很少有 DC 直径减小，框架完整，无迁移迹象。在高频超声上，包裹在阔筋膜或 Lyomesh®中的 DC 表现为低回声且不均匀区域，清晰地被一层薄的高回声包膜材料所限制，而嵌入 PRF 中的 DC 表现为低回声区域，沿着两侧的骨和鼻软骨向两侧扩散。在彩色多普勒成像中，15 例患者中有 7 例在术后检查时发现 DCF 的新生血管化。
高分辨率超声是一种准确、非侵入性的成像方法，适用于可视化增强鼻整形术中的 DCF。此外，通过彩色多普勒成像可以检测到移植物内的新生血管化。
