Mitz V, Maladry D
Service de Chirurgie Orthopédique et Chirurgie Réparatrice, Hôpital Boucicaut, Paris, France.
Ann Chir Plast Esthet. 1996 Feb;41(1):68-74.
The scaphal cartilaginous area is a most suitable anatomic site for cartilaginous graft harvesting. These grafts allow reconstruction of a flat dorsum, or a rounded dome, or alar cartilages or can be used for an extended tip graft. In some cases, both scaphes may be harvested. Raising of the grafts does not leave any sequelae when performed correctly. We have an experience of 20 cases. The main advantage of this graft is its flatness, which makes it ideal for the nasal dorsum. It has to be tailored, moderately crushed and included in a collagen "surgicel" in order to break the shape memory, slightly curved at its borders. We have used scaphal autografts in 15 cases of secondary rhinoplasties, 2 cases of cleft lip repair and in 3 cases of tertiary rhinoplasties. They solved most problems of missing cartilage, when minor defects had to be treated. These grafts will not solve major tissue defects which must be repaired by bone autografts, mostly iliac bone harvesting in our experience. The results of scaphal autografts are stable after 5 years. Resorption is moderate when the graft is correctly inserted, in an extramucosal pocket. The aesthetic result is maintained with a mean follow up of 2 years for 15 cases. The scaphal area of the ear therefore appears to be a favorable donor site for secondary, nose repair; it is easy to harvest, with inconspicuous morbidity and allows the raising of a good, flat and sculpturable material for cartilaginous nose replacement. Achieves the objectives of ore informed patients asking for artistic perfection.
舟状软骨区域是获取软骨移植物最合适的解剖部位。这些移植物可用于重建扁平的鼻背、圆形的鼻尖、鼻翼软骨，或用于延长鼻尖移植物。在某些情况下，双侧舟状软骨均可获取。正确操作时，获取移植物不会留下任何后遗症。我们有20例相关经验。这种移植物的主要优点是其扁平性，这使其成为鼻背的理想选择。必须对其进行修整、适度挤压，并包裹在胶原蛋白“外科用纱布”中，以打破形状记忆，使其边缘略呈弯曲状。我们已将舟状软骨自体移植物用于15例二次鼻整形手术、2例唇裂修复手术和3例三次鼻整形手术。当需要处理轻微缺损时，它们解决了大多数软骨缺失问题。这些移植物无法解决必须通过自体骨移植（在我们的经验中大多是取自髂骨）修复的主要组织缺损问题。舟状软骨自体移植物的效果在5年后是稳定的。当移植物正确植入黏膜下袋时，吸收程度适中。15例患者平均随访2年，美学效果得以维持。因此，耳部的舟状软骨区域似乎是二次鼻修复的理想供区；它易于获取，发病率不明显，并且能够获取优质、扁平且可塑形的材料用于替代鼻软骨。达到了那些追求艺术完美的更明智患者的目标。
