Clinical Study On Transplantation Of Autologous Costal Cartilage To Repair Congenital Severe Saddle Nose Deformity

Objective To discuss the technical points of the surgery which is applied to repair congenital severe saddle nose deformity by fabricating septum extension graft and nasal dorsum graft from autogenous costal cartilage;To evaluate the effectiveness and stability of the surgery by comparing the corresponding parameters in different periods after operation to preoperative ones and normal values.Methods 1.Congenital severe saddle nose deformity of Mongolia population was defined: No nasal organic disease and meeting the following conditions: the depression of nasal dorsum ≥ 6mm,and the difference between the nasal dorsum length and ideal length≥ 8mm,and the nasolabial angle >100 °,and the ratio of tip projection < 0.55;2.According to the definition referred above,20 patients with congenital severe saddle nose deformity were received in our research from January 2016 to December 2017,and all were repaired by the same surgery which fabricated septum extension graft and nasal dorsum graft from autogenous costal cartilage;3.Measured the parameters mentioned above in different periods after operation again,to evaluate the effectiveness and stability of the surgery by comparing the parameters to preoperative ones and normal values.Results 1.A total of 20 cases of congenital severe saddle nose deformity have been researched,all were repaired by the same surgery which fabricated septum extension graft and nasal dorsum graft from autogenous costal cartilage;2.19 cases were measured before the operation,immediately and 3 months after the operation,and 9 cases were followed up more than 12 months after the operation and measured;3.The immediately postoperative parameterscompared with that before the operation: the depression of nasal dorsum and the nasolabial angle decreased(p < 0.01),the nasal dorsum length and the ratio of tip projection are higher than that before the operation(p < 0.01);The immediately postoperative parameters compared with their normal values or ideal values: the depression of nasal dorsum,the nasolabial angle and the ratio of tip projection reached the normal level(p > 0.05),the nasal dorsum length reached the level of ideal value(p > 0.05);4.The parameters in 3 months after the operation compared with immediately postoperative ones: these 4parameters didn’t have statistically significant changes(p > 0.05);the parameters in 3 months after the operation compared with their normal values or ideal values: the depression of nasal dorsum,the nasolabial angle and the ratio of tip projection reached the normal level(p > 0.05),the nasal dorsum length reached the level of ideal value(p > 0.05);5.9 cases were followed up more than 12 months after the operation and measured,the parameters compared with those in 3 months after the operation: these 4 parameters didn’t have statistically significant changes(p > 0.05);the parameters compared with their normal values or ideal values: the depression of nasal dorsum and the ratio of tip projection kept in the normal level(p > 0.05),the difference between the nasal dorsum length and the ideal length was about 1.64mm(p <0.05),the nasolabial angle was bigger than the normal value,1.72 ° on average(p < 0.05).Conclusion 1.This study introduced the definition of Mongolian severe saddle nose deformity and its quantifiable diagnostic conditions,they are convenient for objective diagnosis and effect analysis;2.The surgery which fabricated septum extension graft and nasal dorsum graft from autogenous costal cartilage can achieve the purpose of repair by reducing the depression of nasal dorsum and the nasolabial angle,increasing the ratio of tip projection and the nasal dorsum length;3.Long term follow-up and corresponding parameters comparisons between ones in different periods after the operationand the preoperative ones and normal values proved that,this mode of surgury can make the patients with congenital severe saddle nose deformity a good and stable aesthetic form,and it’s worthy of promotion.