Application of Diced Autologous Rib Cartilage for Paranasal Augmentation in Cleft Nose
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ORIGINAL ARTICLE
RHINOPLASTY
Application of Diced Autologous Rib Cartilage for Paranasal Augmentation in Cleft Nose Ying Liang1 • Xiancheng Wang1
Received: 21 August 2020 / Accepted: 20 October 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract Objective This study aimed to investigate the clinical effect of diced cartilage on correcting nasal alar base depression in Asian cleft rhinoplasty. Methods A retrospective study was conducted on 25 patients with nasal deformity, who underwent the second cleft rhinoplasty between January 2018 and January 2020. Autologous costal cartilage was harvested in all the patients to reconstruct the contour of the nose, while the remaining cartilage from the surgery was cut into 1.091.0 mm pieces and filled into the nasal alar base. The preoperative and postoperative effects of visual images were compared and analyzed using Adobe Photoshop CS6 software. The patients were followed up for 8–18 months (mean 12 months) to investigate the satisfaction and complication rate. Results The nasal alar base depression was corrected, and the profile of malformed noses was significantly improved in 25 patients after the surgery. The postoperative effect was satisfactory, and no obvious graft shift or other complications were observed in the follow-up. Conclusions The application of diced cartilage to correct nasal alar base depression after cleft lip surgery is a feasible method. Its advantages include mainly the crafty use of the remaining cartilage and the presentation of a more natural appearance than mass cartilage. Level of Evidence IV 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 the Table of Contents or the online Instructions to Authors www.springer.com/00266.
& Xiancheng Wang [email protected]
Patients
1
Department of Burn and Plastic Surgery, The Second Xiangya Hospital of Central South University, 139 Furong Road, Changsha 410011, Hunan, China
Keywords Cleft rhinoplasty Diced cartilage Paranasal augmentation
Introduction The correction of nasal deformity in patients with a cleft lip is challenging for the structures with complicated anatomical asymmetry in nose subunits on both sides. Moreover, the collapse of the nasal sidewall, depression of the nasal alar base, and deviation of the nasal septum are usually encountered in cleft rhinoplasty, which requires a comprehensive treatment [1, 2]. Several reconstruction methods exist for paranasal depression, such as graft augmentation, nasal alar base release, and direct closure, but no ‘‘gold standard’’ treatment is still available [3]. In recent years, diced cartilage has been frequently used in the field of rhinoplasty for its specific characteristics in terms of satisfying shaping, flexible application, abundant sources, and difficult curling or deformation [4]. However, it seems to be overlooked in paranasal augment
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