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Objective:To introduce a method of combining autologous rib graft and a silicone plate as a composite graft for augmentation rhinoplasty.Methods:Twenty-two female patients were included in this series. Eleven cases had unsatisfactory nasal appearance Nine cases were admitted for postoperative graft warping, and refused to harvest a second costal cartilage, thirteen cases had limited amount of rib graft for harvest. When cartilage was insufficient for a full dorsal onlay graft, a L-shaped silicone nasal implant would be used and carved into a plate-like, so as to make into a composite graft with the cartilage on top of the silicone plate.Results:Up to 12-month follow-up was conducted, averaged 6.2 months. One case exhibited temporary ischemic signs at the incisions, resolved by compressive taping at day 5.For all other 21 cases aesthetic outcomes were satisfactory with no graft infection, extrusion or other complications. The dorsal only graft did not significantly transilluminate.Conclusions:Rib-silicone composite dorsal graft is an applicable and safe method in augmentation rhinoplasty surgeries, particularly when there is limited amount of cartilage available.
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Objective:To explore the method of constructing nasal cartilage scaffold with fine refinement.Methods:From 2010 to 2018, 212 patients with nasal reconstruction were admitted to the Center of Rhinoplasty and Reconstructive Surgery Hospital of Chinese Academy of Medical Sciences.Results:The stent structure of all patients was composed of nasal dorsal graft, nasal alar support graft, nasal columella support graft, shield graft, lateral nasal cartilage support graft, hat graft, etc.Conclusions:The reconstructed nose presents a more delicate appearance after the later modification compared with the traditional simple l-shaped cartilage stent, and the patient satisfaction is high.
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The facial artery perforator flap has the advantages of minimal donor site morbidity, acceptable appearance and function at recipent area, which brings its wide application in reconstruction of facial small and medium-sized defects. Nasal defects, as the most important aesthetic unit at face, require three-dimennsional and precise reconstruction. The article reviewed the anatomic study and the current status of the clinical applications of this technique in reconstruction of nasal defects, as well as the existing questions. The prospective application of SPY system in localization of facial artery perforator was also analyzed.
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Objective@#The purpose is to investigate the validity of a surgical technique that utilizes autologous costal cartilage grafts in primary rhinoplasty for female patients.@*Methods@#From July 2015 to July 2017, 137 cases received primary rhinoplasty with various types of grafts originated from autologous costal cartilage to correct the unpleasant nasal appearances including low dorsum, poorly defined nasal tip and wide alar base.@*Results@#With 6 to 36 months follow-up, six patients(4.3%) exhibited noticeable changes in nasal contour due to graft warping. Revision surgeries were commenced to correct those minor deformities, resulting in satisfactory outcome.All other cases presented significant improvements of the nasal appearance.@*Conclusions@#Autologous costal cartilage is a good source for primary rhinoplasty cases.
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OBJECTIVE@#There are many scaffold materials of repairing nasal alar cartilage defects. Auricuiar cartilage was used extensively in terms of its abundant tissues, good elasticity, little donor-site malformation, good plasticity etc. The authors dissected auricular cartilage and nasal alar cartilage, measured cartilage's morphous data and found some similar territories with nasal alar cartilage in the structure of auricular cartilage.@*METHOD@#An anatomical study was performed using 10 adult cadavers acquired through Plastic Surgery Hospital, Peking Union Medical College, Beijing, China. Seven male and three female cadav-ers were included in the study. Harvest 20 auricular cartilage specimens and 20 nasal alar cartilage specimens. Then, Computed Tomography Scan on the auricular cartilage and nasal alar cartilage were performed. The datas were imported into mimics and three-dimensional reconstructions of the auricular cartilage and nasal alar cartilage were carried on.@*RESULT@#Parts of the auricular cartilage, such as conchal fossa, tragus, intertragic notch, and cymba of auricular concha, curs of helix and curs of helix, triangular fossa, are ana-tomically similar to nasal alar cartilage.@*CONCLUSION@#This study reports the anatomy of auricular cartilage and nasal alar cartilage, found some territories in the auricular cartilage, such as conchal fossa, tragus, intertragic notch, and cymba of auricular concha, curs of helix and curs of helix, triangular fossa, are anatomically similar to nasal alar cartilage. This research provides the anatomical basis that auricular cartilage was used to repair the nasal cartilage defect.
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Adult , Female , Humans , Male , Cadaver , Ear Auricle , Ear Cartilage , Nasal Cartilages , Plastic Surgery Procedures , Tomography, X-Ray ComputedABSTRACT
Objective To conduct a morphologic and anatomic study on nasal cartilages (including nasal alar cartilage, nasal septal cartilage and upper lateral cartilage) in Chinese, and to compare measured parameters with the other races. Methods 20 adult embalmed cadavers were dissected, 40 nasal alar cartilages, 20 nasal septal cartilages and 40 upper lateral cartilages were collected and scanned by CT, and three-dimensional images were reconstructed. As Zelnik' and Ofodile's work, the data of the images were collected. Results The distances from the nostril rim to the caudal boarder of the lateral crus in the series were (4. 54 ±0. 59) mm anteriorly, (5. 54±0. 69) mm in the middle, and (10. 45± 1. 15) mm posteriorly. The length of the lateral crus was (18. 51 ±1. 63) mm, the width was (7. 99±1. 66) mm, and the thickness was (0. 49±1. 28) mm. Conclusion The Caucasian nasal cartilages are the biggest in all races, and the other's were approximately same.
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Objective To study the action and mechanism of staphylococcal exfoliative toxin A(E-TA)on pemphigus foliaceus antigen(PFA)and pemphigus vulgaris antigen(PVA)expressed on cultured human keratinocytes.Methods Stratified human keratinocytes were incubated with ETA and then stained with sera from patients with pemphigus foliaceus or pemphigus vulgaris as the first antibodies and FITC-la-beled sheep anti-human IgG as the second antibody.Total protein was harvested from the cells pretreated with ETA and run on SDS-PAGE for Western blot with the same antibodies.Simultaneously,supernatants of the keratinocytes before and after ETA treatment were collected for detection of the levels of IL-1?,IL-6with ELISA kits.The caseinolytic activities of the supernatants were tested by spectrometry in which casein was used as a non-specific substrate.Results Down-expression of PFA was shown after ETA treatment while no change of PVA expression was found.The high intensity and continuous linear appearance of fluo-rescent staining before ETA treatment became weak and discontinuous after ETA treatment,which were re-covered gradually in24hours.The degradation of proteins recognized by PF sera after ETV treatment was revealed by Western blot.The decreasing tendency of IL-1?concentration was found in the supernatants of cell culture after ETA treatment,but IL-6level was too low to be detected.Increased caseinolytic activities were found in the supernatants,and declined36hours after ETA treatment.Conclusions ETA acts on PFA expressed on keratinocytes in vitro,which is reversible along with withdrawal of ETA.The mechanism of E-TA act on PFA may be related to proteolytic action instead of promoting cytokine secretion.