Absorbable Plate as a Perpendicular Strut for Acute Saddle Nose Deformities

Abstract

BackgroundNasal pyramid fractures accompanied by saddle nose deformities are not easily corrected by closed reduction. We used an absorbable plate as a perpendicular strut to support the collapsed "keystone area" and obtained good results.MethodsBetween September 2008 and June 2011, 18 patients who had nasal pyramid fractures with saddle nose deformities underwent surgery. Pre- and postoperative facial computed tomographic images and photographs were taken to estimate outcomes. The operative technique included the mucoperichondrial dissection of the nasal septum, insertion of an absorbable plate prepared to an appropriate length to support the "keystone area", and fixation of the absorbable plate strut to the cartilaginous septum.ResultsFunctional and esthetic outcomes were satisfactory in all patients. Eleven patients assessed the postoperative appearance of the external nose as 'markedly improved' and 7 patients as 'improved'. The 5 surgeons scored the results as a mean of 4.5 on a 5-point scale.ConclusionsThe use of an absorbable plate as a perpendicular strut requires no additional procedures because the plate is gradually absorbed. The mechanical strength provided by a buttress between the "keystone area" and the maxillary crest lasts for a long time before the strut is absorbed.

Various Applications of Deep Temporal Fascia in Rhinoplasty

“…28 For such reasons, methods have also been introduced that support the remaining L-strut using an absorbable plate as batten after harvesting as much as septal cartilage as possible. 15 , 29 , 30 Likewise, even when the maximum amount of septal cartilage is obtained in Asians, grafting diced cartilage with DTF for the full length of the dorsum without utilizing rib cartilage is vastly insufficient in many cases, as most of the cartilage would be consumed for tip plasty. Furthermore, patients who undergo reoperation or who have had septal injury lack septal cartilage; thus, most of the diced cartilage graft with DTF is mainly utilized in the correction of radix graft or dorsal tip irregularity.…”

Problems Associated with Alloplastic Materials in Rhinoplasty

“…Most literatures indicate that pHDPE was used as a spreader graft, and that the complication rates were significantly lower compared to when pHDPE was used as a columellar strut. 16 , 17 , 18 , 19 , 20 Based on their bivariate analysis, Winkler, et al 21 reported that the relative risk of postoperative infection from the use of pHDPE as a columellar strut was 21.24%, being approximately 5 times higher than 4.11% shown with the use of expanded polytetrafluoroethylene as the dorsal onlay. Our own experiences indicate that the surgical removal of Medpor® was extremely complicated compared to that of other alloplastic materials.…”

In Vivo Effects of Adipose-Derived Stem Cells in Inducing Neuronal Regeneration in Sprague-Dawley Rats Undergoing Nerve Defect Bridged with Polycaprolactone Nanotubes

“…This has led to the development of many synthetic biomaterials such as silicone, poly-tetrafluorethylene (PTFE), poly-L-glycolic acid (PLGA), poly-caprolactone (PCL) and poly-L-lactic acid (PLLA) ( 9 , 10 ). In addition, natural polymers, such as chitosan, collagen, chitin, gelatin and conducting polymers, such as polypyrrole, polyaniline or polythiophene derivatives, are also widely used for nerve regeneration ( 11 , 12 ). Nevertheless, they have a lack of the effects in inducing the nerve regeneration.…”