Абстракт

Objectives: The gold standard for augmentation rhinoplasty is the harvest of rib cartilage for bridge elevation as well as nasal tip definition. Autologous rib cartilage is the only biocompatible material that is readily available and abundant in the body. However not all patients wants a secondary chest scar as well as the added morbidity resulting from the rib cartilage harvest. The author's objective is to provide an alternative surgical procedure that is safe, worry free, natural looking with the same complication rate as that of autologous rib rhinoplasty. Introduction: Rhinoplasty is cosmetic surgery that is performed to reshape the nose. The use of grafts, such as rib cartilage, is a common part of rhinoplasty when significant structural changes are needed or when significant amounts of additional material are needed to achieve the desired results. Irradiated rib cartilage is one of the types of graft material that can be used in rhinoplasty. It's harvested from a donor, sterilized with radiation to kill any potential diseases or pathogens, and then used in other patients. Materials / method: A total of 121 patients who complained of low nasal dorsum and weak tip support underwent open structural rhinoplasty using the irradiated rib as a saddle graft anchored on the caudal portion of the quadrangular (septal) cartilage. PDS 5-0 suture was used to stabilize the graft in 3 points to prevent collapse, dislocation or derotation of the irradiated rib. The irradiated dermis on the other hand was placed on the nasal dorsum and was carved according the desired nasal height and width of the patient. Results: More than 92% of the patients were satisfied with the results of the surgery. There were 4 cases of nasal tip deviation, 4 cases of asymmetric nostrils, 1 case of nasal tip show. Patients’ satisfaction was graded as 1. Very satisfied 2. Satisfied 3. No change 4. Dissatisfied 5. Very dissatisfied. More than 90% were very satisfied, 2% satisfied and 8% unsatisfied. Conclusion: Conclusion: the use of irradiated rib is a superior material that can be used for nasal tip definition and nasal elongation without the need to harvest the septal cartilage or rib cartilage. Due to the relative weakness of the septal cartilage of the Asian noses, the use of the irradiated rib can provide good tip support especially when anchored with the caudal portion of the quadrangular cartilage properly. In addition, there is no need to prolong the surgery and harvest patients own rib cartilage and thus preventing a secondary chest scar and added morbidity from the harvest.