Correction of severe columella and tip retraction in silicone implanted Asian short noses.

Details

Ressource 1Download: BIB_7D7185BB1819.P001.pdf (1838.18 [Ko])
State: Public
Version: author
Serval ID
serval:BIB_7D7185BB1819
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Correction of severe columella and tip retraction in silicone implanted Asian short noses.
Journal
Journal of Otolaryngology - Head and Neck Surgery = Le Journal D'oto-rhino-laryngologie et De Chirurgie Cervico-faciale
Author(s)
Sertel S., Venara-Vulpe I.I., Pasche P.
ISSN
1916-0216 (Electronic)
ISSN-L
1916-0208
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
45
Number
1
Pages
19
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
BACKGROUND: Silicone Implants and other alloplastic materials are frequently used in rhinoplasty to augment Asian short noses. However, nasal deformities as a result of implant-related infections are increasing in incidence. The resulting tissue scarrings hinder the application of traditional techniques of lengthening short noses. The following paper presents a technique to correct severe postoperative retractions of the tip and columella caused by silicone implants.
METHODS: We present a retrospective case study of two Asian patients with recurrent acute infections, secondary to silicone dorsum implants, leading to chronic inflammation of the tip and columella. The treatment consisted of implant removal and the immediate nasal reconstruction by combining uni- or bilateral gingivobuccal flaps along with L-shaped costal cartilage grafting. To evaluate the surgical results, various anthropometric measurements, particularly the nasal length (NL) and nasal tip projection (NTP) of pre- and postoperative profile photographs, were analyzed.
RESULTS: Successful nasal lengthening and correction of columellar retraction were achieved. In case I, postoperative NTP and NL increased by 34.7% and 21.1%, respectively. In case II, NL and NTP increased by 23.8% and 10.6%, respectively. However, case II presented necrosis of the distal extremity of one gingivobuccal flap without rib graft resorption, which later healed by secondary intention.
CONCLUSION: Pronounced columellar retraction in severe short noses can be successfully managed with a combination of gingivobuccal flaps along with L-shaped costal cartilage grafting. The use of autologous materials decreases the risk of long-term extrusion through the tip. The gingivobuccal flap provides vascularity to the exposed rib cartilage on the columella and prevents its resorption.
Keywords
Adult, Female, Humans, Male, Nasal Septum/surgery, Reoperation, Retrospective Studies, Rhinoplasty/methods, Silicones/adverse effects, Surgical Flaps, Thailand
Pubmed
Open Access
Yes
Create date
17/03/2016 18:22
Last modification date
20/08/2019 14:38
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