Tunneled Paranasal Augmentation Using Diced Autologous Costal Cartilage in Asian Rhinoplasty: A Comparative Study

Guangxian Lin; Xu Yihao; Xulong Zhang; Jianjun You; Huan Wang; Ruobing Zheng; Le Tian; Junsheng Guo; Zhen Song; Fei Fan

doi:10.1055/a-2296-3105

Facial Plastic Surgery, Inhaltsverzeichnis

Facial Plast Surg 2025; 41(02): 250-259
DOI: 10.1055/a-2296-3105

Original Research

Tunneled Paranasal Augmentation Using Diced Autologous Costal Cartilage in Asian Rhinoplasty: A Comparative Study

Guangxian Lin

¹Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China

,

Xu Yihao

¹Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China

,

Xulong Zhang

¹Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China

,

Jianjun You

¹Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China

,

Huan Wang

¹Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China

,

Ruobing Zheng

¹Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China

,

Le Tian

¹Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China

,

Junsheng Guo

¹Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China

,

Zhen Song

¹Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China

,

Fei Fan

¹Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China

› Institutsangaben

Abstract

Due to the prevalence of anterior maxilla dysplasia in Asian population, paranasal concavity is a common accompaniment to low nose, but its impact on facial harmonization is often underestimated. A retrospective comparative study was conducted on patients diagnosed as low nose with paranasal concavity between June 2017 and June 2021, with a total of 56 patients followed up successfully. The control and observation groups were established according to whether the paranasal augmentation was performed. Demographic data were collected. Cosmetic enhancement was quantitatively evaluated by sagittal planimetry, establishing related anatomical landmarks and measuring columella base prominence (CBP) and alar base prominence (ABP). Subjective evaluation concluded the patient-reported satisfaction (FACE-Q-Rhinoplasty Module and Facial Appearance Module) and the third-party physician assessment (Global Aesthetic Improvement Scale, GAIS).

Significant improvements in CBP and ABP were reported both in the control and the observation group (p < 0.01). In postoperative intergroup comparisons, the observation group was superior to the control group regarding ABP values (2.5 ± 0.75 degrees, p < 0.01), FACE-Q-Facial scores (7.49 ± 3.70, p < 0.05), and GAIS scores (p < 0.05). However, no statistical difference was found in CBP values and FACE-Q-Rhinoplasty scores. Paranasal augmentation-related complications included asymmetry of alar bases (6.9%) and facial or intraoral foreign body sensation (34.5%). This study affirmed that paranasal augmentation using diced costal cartilage in rhinoplasty is a safe procedure effective in remedying paranasal concavity and improving facial satisfaction.

Level of Evidence: IV

Keywords

paranasal concavity - rhinoplasty - costal cartilage

Volltext

Referenzen

References
1 Zhang L, Tang M-Y, Jin R. et al. Classification of nasolabial folds in Asians and the corresponding surgical approaches: by Shanghai 9th People's Hospital. J Plast Reconstr Aesthet Surg 2015; 68 (07) 914-919
2 Forte AJ, Steinbacher DM, Persing JA, Brooks ED, Andrew TW, Alonso N. Orbital dysmorphology in untreated children with Crouzon and Apert syndromes. Plast Reconstr Surg 2015; 136 (05) 1054-1062
3 Tripathi NV, Hakimi AA, Parsa KM, Bartholomew IY, Reilly MJ, Chu E. Complications, treatment, and outcomes of self-injecting substances into the face: a systematic review. Dermatol Surg 2024; 50 (01) 59-61
4 Limongi RM, Tao J, Borba A. et al. Complications and management of polymethylmethacrylate (PMMA) injections to the midface. Aesthet Surg J 2016; 36 (02) 132-135
5 Gruber RP, Freeman MB, Hsu C, Elyassnia D, Reddy V. Nasal base reduction: a treatment algorithm including alar release with medialization. Plast Reconstr Surg 2009; 123 (02) 716-725
6 Zhao R, Pan B, Li D, An Y. Application of paranasal augmentation rhinoplasty in Asians with midfacial concavity. Ann Plast Surg 2023; 90 (5S, Suppl 2) S147-S152
7 Bahşi I, Orhan M, Kervancioğlu P, Karatepe Ş, Sayin S. External nose anthropometry of healthy Turkish young adults. J Craniofac Surg 2021; 32 (06) 2226-2229
8 Ottenhof MJ, Veldhuizen IJ, Hensbergen LJV. et al. The use of the FACE-Q aesthetic: a narrative review. Aesthetic Plast Surg 2022; 46 (06) 2769-2780
9 AlOtaibi NM, Liu C-H, Benington PCM, Ayoub AF. Improvement in facial aesthetics of orthognathic patients after surgery-first approach. Br J Oral Maxillofac Surg 2023; 61 (10) 666-671
10 Park J-H, Kim J-W, Kim S-J. Midfacial soft-tissue changes after paranasal augmentation with porous polyethylene. Facial Plast Surg 2016; 32 (02) 232-237
11 Lee T-Y, Chung H-Y, Dhong E-S, Jeong SH, Han SK. Paranasal augmentation using multi-folded expanded polytetrafluorethylene (ePTFE) in the East Asian nose. Aesthet Surg J 2019; 39 (12) 1319-1328
12 Rohrich RJ, Hoxworth RE, Thornton JF, Pessa JE. The pyriform ligament. Plast Reconstr Surg 2008; 121 (01) 277-281
13 Gruber RP, Freeman MB, Hsu C, Elyassnia D, Reddy V. Nasal base reduction by alar release: a laboratory evaluation. Plast Reconstr Surg 2009; 123 (02) 709-715
14 Ponsky D, Guyuron B. Alar base disharmonies. Clin Plast Surg 2010; 37 (02) 245-251
15 Peleg O, Mahmoud R, Shuster A. et al. Orthognathic surgery complications: the 10-year experience of a single center. J Craniomaxillofac Surg 2021; 49 (10) 891-897
16 Ulkur F, Uyar VO, Ozdemir F, Guzel MZ. Interdisciplinary orthognathic treatment of high angle class III malocclusion. Niger J Clin Pract 2015; 18 (01) 144-148
17 Wang G, Wei M, Zhen Y. et al. Three-dimensional morphological study on the effectiveness of expanded polytetrafluoroethylene prosthesis in the paranasal augmentation. Aesthetic Plast Surg 2023
18 Zhai Z, Zhao J, Qi Z. Paranasal augmentation: a viable and simplified modality with diced expanded polytetrafluoroethylene. J Craniofac Surg 2022; 33 (06) e613-e616
19 Kim JH, Jung MS, Lee BH, Jeong HS, Suh IS, Ahn DK. Silicone implant-based paranasal augmentation for mild midface concavity. Arch Craniofac Surg 2016; 17 (01) 20-24
20 Schwaiger M, Echlin K, Atherton D, Haers P. The use of Medpor implants for midface contouring in cleft patients. Int J Oral Maxillofac Implants 2019; 48 (09) 1177-1184
21 Lee TS, Park S. Use of pedicled buccal fat pad for midface augmentation. J Craniofac Surg 2017; 28 (08) 2133-2134
22 Choung PH, Kim SG. The coronoid process for paranasal augmentation in the correction of midfacial concavity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 91 (01) 28-33
23 Jeon Y-T, Han S-J. Comparative study of the effect of paranasal augmentation with autologous bone in orthognathic surgery. J Oral Maxillofac Surg 2019; 77 (10) 2116-2124
24 Sabuncuoglu F, Varol A, Sençimen M, Olmez H. Onlay iliac bone grafting as an ancillary augmentation procedure for paranasal rejuvenation during bimaxillary surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109 (02) e13-e19
25 Park H, Chun K-W, Kye M-S, Dhong ES, Yoon ES. Midface augmentation using bony segments obtained from sagittal splitting angle ostectomy in Asians. Plast Reconstr Surg 2008; 121 (02) 578-586
26 Remache D, Caliez M, Gratton M, Dos Santos S. The effects of cyclic tensile and stress-relaxation tests on porcine skin. J Mech Behav Biomed Mater 2018; 77: 242-249
27 Mendelson B, Wong C-H. Changes in the facial skeleton with aging: implications and clinical applications in facial rejuvenation. Aesthetic Plast Surg 2020; 44 (04) 1151-1158
28 Lin SI, Hsiao Y-C, Chang C-S, Chen PK, Chen JP, Ueng SH. Histology and long-term stability of diced cartilage graft for revision rhinoplasty in a cleft patient. Plast Reconstr Surg Glob Open 2016; 4 (06) e763
29 An Y, Zhen Y, Ye W. et al. Diced costal cartilage graft combined with muscle repositioning improves cleft-side alar asymmetry in Asian secondary unilateral cleft rhinoplasty: a three-dimensional evaluation. J Plast Reconstr Aesthet Surg 2021; 74 (09) 2265-2271
30 Yu MS, Kim B-H, Kang S-H, Lim DJ. Combined use of crushed cartilage and fibrin sealant for radix augmentation in Asian rhinoplasty. Plast Reconstr Surg 2015; 135 (02) 293e-300e
31 Dong W, Xu Y, Han R. et al. Paranasal augmentation using diced costal cartilage for midface concavity: a retrospective study of 68 patients. Aesthetic Plast Surg 2021