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纤维蛋白胶、富血小板血浆(PRP)和温血作为鞍鼻畸形中切碎软骨支架的功能和美学效果:一项描述性研究。

The Functional and Aesthetic Results of Fibrin Glue, Platelet-Rich Plasma (PRP), and Warm Blood as a Scaffold for Diced Cartilage in Saddle Nose Deformity: A Descriptive Study.

作者信息

Rabie Amr Nabil, El Samny Talat Ali, Askoura Anas Mohammad, Desouky Mohamed Salah, Aty Ahmed Mohamed Kamel Abdel

机构信息

Department of Otorhinolaryngology, Ain Shams University, Cairo, Egypt.

出版信息

Facial Plast Surg. 2025 May 19. doi: 10.1055/a-2597-6450.

Abstract

Irregularities on the nasal dorsum post rhinoplasty remain a prevalent concern for both surgeons and patients. Various techniques using cartilage are used to hide the nasal dorsum, such as crushed cartilage, free diced cartilage, surgical-wrapped diced cartilage, or diced cartilage mixed with blood glue. Diced cartilage can address issues that arise with solid materials. However, it may lead to undesirable outcomes such as graft deformation and migration. It is challenging to uniformly implant the loosely linked cartilage pieces. To prevent issues, cartilage is mixed with other materials to serve as a stabilizing scaffold.This descriptive study will examine fibrin glue, platelet-rich plasma (PRP), and warm blood as stabilizing scaffolds for correcting saddle nose deformity.To compare functional and aesthetic results of the fibrin glue, PRP, and warm blood usage with diced cartilage for correction of saddle nose deformity in rhinoplasty as a descriptive study.This prospective interventional study was conducted on 30 patients with saddle nose undergoing rhinoplasty with dorsal nasal augmentation using three materials to collide the diced cartilage. All patients were divided into three groups: Study group 1 includes 10 patients who used fibrin glue. Study group 2 includes 10 patients who used PRP. Study group 3 includes 10 patients who used warm blood in Otorhinolaryngology Department, Faculty of Medicine, Ain Shams University hospitals from August 2021 till July 2023. The study was approved by an ethical committee before the start of the recruitment (FMASU M D 44/2021).Our study included 19 primary and 11 revision cases. The mean age of the patients was 31.10 years. Mean postoperative follow-up period was 12 months. There was a statistically significant improvement in rhinoplasty outcome evaluation score (ROE) and dorsal height postoperatively among the studied patients with -value <0.001, with no statistical difference between the three different groups regarding postoperative resorption.One can augment the nasal dorsum significantly with diced cartilage combined with any of the three different materials, fibrin glue, PRP (PRP), or warm blood, guided by the availability of prerequisites of each material. As the warm blood can fit any patient with no required complex tools, it seems to be the best material to correct saddle nose and maintain the nasal dorsal height.

摘要

隆鼻术后鼻背不规则仍然是外科医生和患者普遍关注的问题。使用软骨的各种技术被用于遮盖鼻背,如碎软骨、游离切碎软骨、手术包裹切碎软骨或与血胶混合的切碎软骨。切碎软骨可以解决使用固体材料时出现的问题。然而,它可能会导致不理想的结果,如移植物变形和移位。均匀植入松散连接的软骨块具有挑战性。为防止出现问题,软骨会与其他材料混合以作为稳定支架。这项描述性研究将研究纤维蛋白胶、富血小板血浆(PRP)和温血作为矫正鞍鼻畸形的稳定支架。作为一项描述性研究,比较纤维蛋白胶、PRP和温血与切碎软骨用于隆鼻术中矫正鞍鼻畸形的功能和美学效果。这项前瞻性干预性研究对30例接受隆鼻术并使用三种材料填充切碎软骨进行鼻背增高的鞍鼻患者进行。所有患者分为三组:研究组1包括10例使用纤维蛋白胶的患者。研究组2包括10例使用PRP的患者。研究组3包括10例在2021年8月至2023年7月于艾因夏姆斯大学医学院附属医院耳鼻喉科使用温血的患者。该研究在招募开始前获得了伦理委员会的批准(FMASU M D 44/2021)。我们的研究包括19例初次手术和11例修复手术病例。患者的平均年龄为31.10岁。术后平均随访期为12个月。研究患者术后隆鼻效果评估评分(ROE)和鼻背高度有统计学显著改善,P值<0.001,三组之间术后吸收情况无统计学差异。在每种材料前提条件允许的情况下,切碎软骨与三种不同材料(纤维蛋白胶、PRP或温血)中的任何一种结合都可以显著增高鼻背。由于温血适用于任何患者且无需复杂工具,它似乎是矫正鞍鼻和维持鼻背高度的最佳材料。

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