[Diced cartilage used in rhinoplasty procedures].

Claudia Völklein,Herbert Riechelmann

LARYNGO-RHINO-OTOLOGIE(2019)

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摘要
An even and aesthetically modelled surface of the nasal dorsum and the tip of the nose is the desired end result of septorhinoplasty procedures for both the surgeon and the patient. When using DC for septorhinoplasty and the variations of the DCF (diced cartilage framework), almost only autologous materials with high biocompatibility and a consecutively minimized risk of infection and rejection are preferred. Histological investigations postulate a regenerative potential for DC and DCF by adding PRF (platelet rich fibrin) from the patient's own plasma. The production of DC and DCF from autologous cartilage is easy to learn and can be prepared by the surgical assistant parallel to the procedure. The preparation of the PRF is standardized. The shape and size of the DC grafts are very variable, as is the place of application at the nose. The DC can be applied freely under the skin or wrapped as a framework (DCF) with autologous fascia, perichondrium and aPRF (advanced platelet rich fibrin) clot. The DCF graft can still be resculpted a few days after insertion. No overcorrection should take place, as the graft remains constant in mass and is not resorbed. DC and DCF grafts do not improve the structure and are only suitable for contour modelling. They can be used as a complementary component after a structure-improving build-up of the internal supporting structures of the nose. The adaptation and application of the DC and the DCF therefore always take place at the end of the septorhinoplasty procedure. The ease of use and flexibility of this technique with the goal of a quickly modelable grafts integrating into the contour of the nasal dorsum convince both for FDC (free diced cartilage) and for DCF and can be expressed as a recommendation for routine use for contour modelling in septorhinoplasty.
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