Sheen J H
Department of Surgery, University of Southern California.
Plast Reconstr Surg. 1993 Jan;91(1):48-63. doi: 10.1097/00006534-199301000-00007.
This paper chronicles a personal experience with nasal tip grafts over 20 years. In the first period (1968-1975), the original graft was designed for use in secondary rhinoplasty cases to obtain both projection of the tip and increased angulation at the columellar-lobular junction. The use was soon expanded to primary patients with inadequate tip projection. During the middle period (1975-1982), the applications for tip grafting were expanded to include many kinds of tip problems (both primary and secondary), cleft lip noses, and various ethnic noses, especially those with thick skin. The incidence of postoperative displacement and/or visibility of the graft was reduced as multiple grafts of solid, bruised, and crushed cartilage became routine. Ear cartilage was first used and ethmoid was abandoned as a primary graft. The incidence of infection was significantly reduced. The current period (1982-1991) is marked by refinements in technique and materials. Greater versatility with graft composition and materials makes possible a variety of tip configurations, custom-made for individual requirements.
本文记录了20多年来鼻尖移植的个人经验。在第一阶段（1968 - 1975年），最初的移植设计用于二次鼻整形手术病例，以获得鼻尖的突出度和鼻小柱 - 小叶交界处角度的增加。其应用很快扩展到鼻尖突出度不足的初次手术患者。在中期（1975 - 1982年），鼻尖移植的应用扩展到包括多种鼻尖问题（初次和二次）、唇裂鼻以及各种种族的鼻子，特别是那些皮肤较厚的鼻子。随着固体、擦伤和压碎软骨的多次移植成为常规操作，移植后移位和/或可见性的发生率降低。首次使用耳软骨，筛骨作为主要移植材料被弃用。感染发生率显著降低。当前阶段（1982 - 1991年）的特点是技术和材料的改进。移植成分和材料的更大通用性使得能够根据个体需求定制各种鼻尖形态。
