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Augmentation des Nasenrückens mit Knorpelschrot-Fibrinkleber

Nasal dorsal augmentation with a diced cartilage glue graft

  • Leitthema
  • Published:
Journal für Ästhetische Chirurgie Aims and scope

Zusammenfassung

Hintergrund

Die optimale Methode für die Augmentation des Nasenrückens wird aufgrund charakteristischer Vor- und Nachteile von alloplastischen Materialien und autologen Geweben weiterhin kontrovers diskutiert. Diese Übersicht beleuchtet eine Variante der Verwendung von autologem Knorpelschrot.

Wissensstand

In der westlichen Welt hat sich zunehmend die Verwendung von autologen Geweben, vor allem Knorpelschrot in einer Faszienhülle („diced cartilage fascia graft“) als Goldstandard durchgesetzt. Diese Übersicht beleuchtet unterschiedliche Augmentationstechniken und beschreibt eine Modifikation eines Knorpelschrottransplantats unter Verwendung von Fibrinkleber im Detail. Bei dieser Technik wird der Knorpel mit thrombinhaltiger Lösung imprägniert, in die gewünschte Form gebracht und anschließend mit fibrinogenhaltiger Lösung gebunden. Diese Technik erweitert das Spektrum der möglichen Transplantatformen wesentlich. Die Anwendung seit mehr als fünf Jahren sowie eine morphometrische Studie mit einem 15-monatigen Follow-up belegen die langfristige Stabilität der Transplantate.

Schlussfolgerung

Die Verwendung von autologen Geweben für die Nasenaugmentation entspricht den Wünschen der Mehrzahl der Patienten und Operateure. Das Knorpelschrot-Fibrinkleber-Transplantat hat sich als Ergänzung des rhinochirurgischen Repertoires bewährt.

Abstract

Background

The ideal method for augmentation of the nasal dorsum has yet to be found due to specific characteristics of alloplastic materials and autologous tissue. This review article describes a variation of the use of autologous diced cartilage.

Current opinion and practice

In the western world the use of autologous tissue has increasingly become accepted as the gold standard, particularly as a diced cartilage glue graft wrapped in fascia. This review discusses various augmentation techniques and details of a modification of a diced cartilage transplant using fibrin glue. This technique is innovative by impregnating diced cartilage with a thrombin solution, moulding it into the desired form and finally bonded with a fibrin solution. This technique substantially extends the spectrum of possible transplant forms. Its application for more than 5 years and a morphometric study with a 15-month follow-up confirm the long-term stability of the transplant.

Conclusion

The use of autologous tissue for augmentation of the nose is in line with the wishes of the majority of patients and surgeons. The diced cartilage glue graft has proved to be a welcome addition to the rhinoplasty armamentarium.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. A.-J. Tasman, P.-A. Diener und R. Litschel geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben. Im Falle von nicht mündigen Patienten liegt die Einwilligung eines Erziehungsberechtigten oder des gesetzlich bestellten Betreuers vor.

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Authors and Affiliations

  1. Rhinologie, plastische Gesichtschirurgie, Hals-Nasen-Ohrenklinik, Kantonsspital St. Gallen, Rorschacherstr. 95, 9000, St. Gallen, Schweiz

    A.-J. Tasman & R. Litschel

  2. Institut für Pathologie, Kantonsspital St. Gallen, St. Gallen, Schweiz

    P.-A. Diener

Authors
  1. A.-J. Tasman
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  2. P.-A. Diener
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  3. R. Litschel
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Correspondence to A.-J. Tasman.

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Tasman, AJ., Diener, PA. & Litschel, R. Augmentation des Nasenrückens mit Knorpelschrot-Fibrinkleber. J. f. Ästhet. Chirurgie 7, 150–158 (2014). https://doi.org/10.1007/s12631-014-0307-y

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  • DOI: https://doi.org/10.1007/s12631-014-0307-y

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