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2010, Número 2

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Cir Plast 2010; 20 (2)


Experiencia con rinoplastia cerrada y Spongostan (una posible matriz tridimensional para injerto de cartílago sobre el dorso nasal)

Vallarta RRA, Ortiz LJB, Vázquez AMG

Idioma: Español
Referencias bibliográficas: 39
Paginas: 78-86
Archivo PDF: 617.72 Kb.


RESUMEN

La necesidad de reemplazo del dorso nasal se manifiesta al observar el techo nasal abierto, una superficie irregular, colapso lateral y alteración valvular posterior a la gibectomía. Anatómicamente se requiere un marco osteo-cartilaginoso recto, simétrico y prominente, que se logra mediante la colocación de un injerto cartilaginoso. Es simplista pensar que la gibectomía por sí misma es el procedimiento universal aplicable para lograr un dorso nasal recto, sin considerar la altura, anchura, longitud, regularidad en la superficie, función valvular y percepción óptica global de la nariz. Los injertos de cartílago envueltos en esponja Spongostan® (Johnson & Johnson), se han utilizado de manera experimental para el relleno de defectos tridimensionales y dinámicos en superficies articulares con resultados positivos para la diferenciación condrocitaria y disminución de la diferenciación. Reportamos la experiencia de 3 años con la utilización de este material como medio de contención y posible marco tridimensional que permite mejorar la viabilidad, estabilidad y proliferación condrocitaria en el reemplazo del dorso nasal en rinoplastias primarias y secundarias; discutimos sus ventajas, desventajas y resultados a largo plazo.


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