Chinese Journal of Reparative and Reconstructive Surgery
Supervisor： National Health Commission of the People's Republic of ChinaSponsor： Chinese Association of Rehabilitation Medicine , Sichuan University Editor-in-chief：Bin Shen Publishing period：
Monthly
ISSN：1002-1892CN：51-1372/R
ObjectiveTo explore the application and effectiveness of thin-ribbed cartilage with the perichondrium in the correction of secondary cleft lip nasal deformity as the lateral crural onlay graft.MethodsA retrospective study was performed based on the data of 28 patients with secondary nasal deformity of cleft lip between October 2015 and April 2017. There were 16 males and 12 females with an average age of 24 years (range, 18-31 years). There were 11 cases with secondary nasal deformities on the left side, 13 cases on the right side, and 4 cases on both sides. Three-dimensional stereotaxy of the nasolabial muscles was used to correct the deformity. The costal cartilage as the support was used to perform nasal columella and nasal dorsum while the thin-ribbed cartilage with the perichondrium was used as wing cartilage support. The photography of nasal position was taken before operation and at 6-8 months after operation. The midpoint of the junction between the nasal columella and the upper lip was marked point O; the lateral horizontal line passing through the point O was marked as X-line, and the longitudinal line (the midline) as Y-line. The distance of the highest point of the affected nostril to the X-line, the distance of the nostril’s outermost point to the Y-line, the symmetries of both the most lateral and the highest point of the bilateral nostrils, and the distance of the highest point of the nasal tip to the X-line were measured.ResultsAll incisions healed by first intention. All patients were followed up 6 to 24 months with an average of 12 months. The size and shape of the noses were stable, and no compli cation, such as cartilage exposure, hematoma, or infection occurred during the postoperative follow-up. There were 4 cases with obvious incision scars, 3 cases with nostril and alar asymmetry, and 1 case of lateral side of the nose without well positioned. The symmetry of the highest points of bilateral nostrils was 57.643%±27.491% before operation and 90.246%±18.769% after operation. The symmetry of the most lateral points of the bilateral nostrils was 77.391%±30.628% before operation and 92.373%±21.662% after operation. And there were significant differences between pre- and post-operation (P<0.05). There were also significant differences in the distance of highest point of the affected nostril to the X-line, the distance of the nostril’s outermost point to the Y-line, and the distance of the highest point of the nasal tip to the X-line (P<0.05). No thoracic contour change occurred at the costal cartilage donor site.ConclusionThe thin-ribbed cartilage with the perichondrium has good support and long-term stability, and it can be used as one of the ideal materials for nasal alar cartilage transplantation for nasal deformity secondary to cleft lip.
Citation：YUAN Ju, WANG Wangshu, YANG Tianye, LI Tian, GENG Yujia, GAO Hai, SHAO Ying. Application of thin-ribbed cartilage with the perichondrium in correction of secondary cleft lip nasal deformity as lateral crural onlay graft. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(5): 601-606. doi: 10.7507/1002-1892.201711147Copy
Copyright ? the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
Bhat U, Garg S, D’Souza EJ, et al. Precision carving of costal cartilage graft for contour fill in aesthetic and reconstructive rhinoplasty. Indian J Plast Surg, 2014, 47(1): 25-35.
12.
Cuzalina A, Jung C. Rhinoplasty for the cleft lip and palate patient. Oral Maxillofacial Surg Clin North Am, 2016, 28(2): 189-202.
Insalaco L, Rashes ER, Rubin SJ, et al. Association of lateral crural overlay technique with strength of the lower lateral cartilages. JAMA Facial Plast Surg, 2017, 19(6): 510-515.
Ryu YA, Jin M, Kang N. Histological, physical studies after xenograft of porcine ear cartilage. Arch Craniofac Surg, 2017, 18(3): 155-161.
20.
Fukuda N, Asato H, Umekawa K, et al. Costal cartilage graft with perichondrium, a possible anti-adhesive material. J Plast Surg Hand Surg, 2016,51(4): 247-253.
11. Bhat U, Garg S, D’Souza EJ, et al. Precision carving of costal cartilage graft for contour fill in aesthetic and reconstructive rhinoplasty. Indian J Plast Surg, 2014, 47(1): 25-35.
12. Cuzalina A, Jung C. Rhinoplasty for the cleft lip and palate patient. Oral Maxillofacial Surg Clin North Am, 2016, 28(2): 189-202.
15. Insalaco L, Rashes ER, Rubin SJ, et al. Association of lateral crural overlay technique with strength of the lower lateral cartilages. JAMA Facial Plast Surg, 2017, 19(6): 510-515.
19. Ryu YA, Jin M, Kang N. Histological, physical studies after xenograft of porcine ear cartilage. Arch Craniofac Surg, 2017, 18(3): 155-161.
20. Fukuda N, Asato H, Umekawa K, et al. Costal cartilage graft with perichondrium, a possible anti-adhesive material. J Plast Surg Hand Surg, 2016,51(4): 247-253.
Click the content below to copy and paste a set citation format。
Citation：YUAN Ju, WANG Wangshu, YANG Tianye, LI Tian, GENG Yujia, GAO Hai, SHAO Ying. Application of thin-ribbed cartilage with the perichondrium in correction of secondary cleft lip nasal deformity as lateral crural onlay graft. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(5): 601-606. doi: 10.7507/1002-1892.201711147
1/5
WeChat