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Nikparto N, Yari A, Mehraban SH, Bigdelou M, Asadi A, Darehdor AA, Nezaminia S, Khani M, Hakim LK, Eskandari F, Erfani M, Tebyaniyan H. The current techniques in dorsal augmentation rhinoplasty: a comprehensive review. Maxillofac Plast Reconstr Surg 2024; 46:16. [PMID: 38678507 PMCID: PMC11056355 DOI: 10.1186/s40902-024-00418-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/13/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND An essential aspect of rhinoplasty is the enhancement of the nasal dorsal contour by performing dorsal augmentation (DA) rhinoplasty. A wide range of techniques are available for DA as the demand for aesthetic nasal refinement grows. This review aims to provide a comprehensive overview of the current techniques used in DA rhinoplasty. MAIN BODY Research articles on DA rhinoplasty techniques were identified through a comprehensive literature search. Scopus, PubMed, and Web of Science were used as electronic databases. Each database was searched for articles published since its inception. DA rhinoplasty techniques were examined in this literature review. Methodological quality was assessed for the selected studies, and data was extracted to examine materials used, surgical approaches, and reported outcomes for each technique. Various DA methods, including autologous grafts and synthetic implants, are examined in-depth in this review. Comparing approaches can help better understand their respective advantages and limitations. CONCLUSION A wealth of techniques is available for DA rhinoplasty, each with advantages. Patients' nasal anatomy, desired outcomes, and potential risks must be considered by surgeons when determining their surgical approach. DA methods continue to evolve rapidly, creating a need for a thorough understanding of the current landscape to make informed decisions.
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Affiliation(s)
- Nariman Nikparto
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Amir Yari
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran
| | - Saeed Hasani Mehraban
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Meysam Bigdelou
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Amirmohammad Arabi Darehdor
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Sayna Nezaminia
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Mehdi Khani
- Resident of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Science, Tehran, Iran
| | | | - Fateme Eskandari
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Erfani
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Tebyaniyan
- Department of Science and Research, Islimic Azade University, Tehran, Iran.
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陆 思, 殷 国. [Research progress of autogenous cartilage scaffold carving method in rhinoplasty]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2021; 35:514-518. [PMID: 33855839 PMCID: PMC8171616 DOI: 10.7507/1002-1892.202010048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/11/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To summarize the research progress of autogenous cartilage scaffold carving method in rhinoplasty. METHODS The relevant literature about the autogenous cartilage scaffold carving methods in rhinoplasty in resent years at home and abroad was reviewed, and the carving skills, shape, and application scope of different parts of nasal scaffolds were summarized and analyzed. RESULTS Willow-leaf shape is still the main method of cartilage scaffold in the back of the nose. However, in nasal reconstruction, it can be carved into an L-shaped scaffold with the nasal columella scaffold through mortise and tenon structure. And it can also crush the autologous cartilage and wrap it with the autologous fascia tissue to form a new nasal dorsal scaffold. The nasal tip scaffold is improved by changing the shape of traditional nasal tip cartilage cap and wrapping with fascia tissue; the nasal alar scaffold has M-shape, q-shape, carving methods; the nasal columella and nasal septum are mostly used "2+2" combined fixed scaffold. The cartilage scaffolds of lateral nose and nasal base are mainly carved in the shape of "" and crescent. CONCLUSION As a rhinoplasty scaffold, there are various carving methods for autogenous cartilage. With the innovation of surgical technique and the improvement of sculpting technique, the effect of autologous cartilage graft in rhinoplasty is getting better and better; meanwhile, tissue engineered cartilage is being applied in rhinoplasty.
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Affiliation(s)
- 思锭 陆
- 广西医科大学第一附属医院整形美容外科(南宁 530021)Department of Plastic and Aesthetic Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning Guangxi, 530021, P.R.China
| | - 国前 殷
- 广西医科大学第一附属医院整形美容外科(南宁 530021)Department of Plastic and Aesthetic Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning Guangxi, 530021, P.R.China
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Choi WR, Jang YJ. Reconstruction of a Severely Damaged Cartilaginous Septum with a Bypass L-Strut Graft using Costal Cartilage. Facial Plast Surg 2021; 37:92-97. [PMID: 33556969 DOI: 10.1055/s-0041-1722957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE Reconstruction of a weakened septal cartilage is a key procedure for the correction of deformed noses. However, when septal mucoperichondrium dissection is technically challenging, reconstruction of the lower two-thirds of the nose should be performed bypassing the damaged septal cartilage and mucosa. This article summarizes our experience with treating patients with severely damaged septal cartilage with bypass L-strut graft using costal cartilage. METHODS We retrospectively reviewed 26 patients who underwent rhinoplasty using bypass L-strut graft. Autologous costal cartilage was used for creating L-strut in two different ways: (1) by fashioning the L-shaped graft as one unit using the sixth rib cartilage and (2) by integrating a dorsal strut with a columellar strut using slices of the seventh rib cartilage. The caudal strut is fixated to the anterior nasal spine; the dorsal L-strut is placed on the nasal dorsum with no fixation to the nasal bone. Medical records were assessed for demographic, clinical, and treatment information. RESULTS One-piece-type L-strut graft was used for 11 patients and integrated-type L-strut graft was used for 15 patients. No statistical differences were found in postoperative aesthetic outcomes between the two groups. The postoperative assessment of surgical outcomes was excellent in 10 patients, good in 10, fair in 6, and poor in none. Functionally, all 26 patients experienced improvements in nasal breathing. CONCLUSION Bypass L-strut graft using costal cartilage is a useful surgical maneuver of septal reconstruction in particular nasal deformity when the creation of the septal mucoperichondrial pocket is difficult or better to be avoided.
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Affiliation(s)
- Woo Ri Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Changwon Hospital, Seoul, Republic of Korea
| | - Yong Ju Jang
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Abstract
PURPOSE OF REVIEW Costal cartilage has many advantages over other grafting materials because of its large quantity and high biocompatibility. As a result, it has been considered as a good option for Asian rhinoplasty. However, costal cartilage is difficult to use and is associated with a high complication rate. To avoid the disadvantages and complications of costal cartilage graft, several techniques have been proposed in the literature. This review addresses the conventional uses of costal cartilage in Asian rhinoplasty and recent updates. RECENT FINDINGS Different techniques have been reported for Asian rhinoplasty using costal cartilage. Solid-block costal cartilage and diced cartilage with or without wrapping materials are widely used for dorsal augmentation. Many different grafting techniques for the tip and septal reconstruction have been reported by numerous surgeons. When using costal cartilage graft, surgeons should pay attention to both graft complications, such as warping or infection, and donor-site morbidity. Several strategies have recently been developed to avoid these complications. SUMMARY This article summarises grafting options for Asian rhinoplasty using costal cartilage and possible complications. This information may assist with proper selection of appropriate techniques for harvesting, carving and grafting costal cartilage.
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