Effectiveness of cross-linked human acellular dermal matrix in primary and revision augmentation rhinoplasty

Sang Chul Park; Jae-Sung Nam; Kyu-In Lee; Young-Woo Lee; Jeong-Jin Park; Jong-Gyun Ha; Hyung-Ju Cho; Joo-Heon Yoon; Chang-Hoon Kim

doi:10.1016/j.bjps.2021.09.062

Effectiveness of cross-linked human acellular dermal matrix in primary and revision augmentation rhinoplasty

J Plast Reconstr Aesthet Surg. 2022 Apr;75(4):1447-1454. doi: 10.1016/j.bjps.2021.09.062. Epub 2021 Oct 22.

Authors

Sang Chul Park¹, Jae-Sung Nam², Kyu-In Lee², Young-Woo Lee², Jeong-Jin Park², Jong-Gyun Ha², Hyung-Ju Cho³, Joo-Heon Yoon³, Chang-Hoon Kim⁴

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck surgery, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.
² Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
³ Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Korea Mouse Phenotyping Center, Seoul, Republic of Korea.
⁴ Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Korea Mouse Phenotyping Center, Seoul, Republic of Korea; Medical Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: entman@yuhs.ac.

PMID: 34955393
DOI: 10.1016/j.bjps.2021.09.062

Abstract

Background: Among the materials used for dorsal augmentation rhinoplasty (DAR), cross-linked human acellular dermal matrix (ADM) has been claimed for its low risk of infection and extrusion. The aim of this study was to compare the effectiveness of ADM in subjects undergoing primary versus revision dorsal augmentation rhinoplasties.

Methods: Using a retrospective cohort study design, the investigators enrolled a cohort set of DAR patients operated by a single surgeon during a 65-month interval. The predictor variable was the treatment group (primary or revision DAR). The main outcome variables were postoperative changes with regard to the degree of augmentation (ratio of the dorsal height [DH] and radix height [RH] to the nasal length) and patients' and surgeons' satisfaction with the aesthetic and functional results. Other study variables were grouped into the following categories: demographic, surgical, and pathological. Descriptive, uni-, and bivariate statistics were computed using P ≤ 0.05 as a cutoff value.

Results: The study cohort comprised 145 subjects (75.2% with primary DAR; 39.3% females) with a mean age of 30.7 ± 9.4 years (range, 19-58). DAR was linked to the significant changes in DH and RH in both the treatment groups. Comparison of the two groups revealed that there was no significant difference in DH and RH between both the groups. Surgeons' and patients' satisfaction rates were comparable between the two surgery groups, neither of which experienced serious complications. Microscopic findings of the removed ADM showed abundant collagen tissue with newly formed vessels without signs of foreign body reaction.

Conclusion: Despite significant differences in patient characteristics (age; number of osteotomy, tip plasty, and hump reduction surgeries), the results of this study suggest that ADM can be used in both primary and revision DAR, with minimal complications.

Keywords: Acellular dermal matrix; Biocompatibility; Dorsal augmentation; Primary rhinoplasty; Revision rhinoplasty.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Acellular Dermis*
Adult
Female
Humans
Male
Nose / surgery
Reoperation / methods
Retrospective Studies
Rhinoplasty* / methods
Treatment Outcome
Young Adult