15年間の長期追跡結果が得られた複合自家組織による隆鼻術の1例

Augmentation Rhinoplasty Using Autologous Composite Grafts: A 15-Year Follow-Up Report

はじめに

　わが国の美容外科における隆鼻術では，主としてⅠ型シリコンインプラントが用いられている 1）。一方，自家組織は生体適合性のある移植材料であるが，吸収や弯曲変形などの合併症および採取部の犠牲があるなどの欠点があるため十分に普及していない。

　自家組織による隆鼻術において，1種類の自家組織を外鼻全体の隆鼻術に使用するのではなく，複数の自家組織を使い分けることでそれぞれの自家組織の欠点を相殺できると考え，著者は2018年，本誌に鼻内法での複合自家組織による隆鼻術（以下，本法）について20例の短期結果を報告した 2）。今回，15年間の長期追跡結果が得られた1例を経験したので報告する。

　In augmentation rhinoplasty, composite grafts can address the limitations of various autologous tissue grafts. In 2018, our research group reported the short-term follow-up results of 20 patients who underwent an augmentation rhinoplasty with autologous composite grafts and septal extension grafts, in this journal. Here, we present a detailed account of the long-term follow-up of one patient.

　The patient was a 20-year-old man who underwent endonasal augmentation rhinoplasty with autologous composite grafts and septal extension grafts at our clinic 15 years ago. His postoperative course was uneventful. Over the years, he also underwent alar surgery three times. A comparative evaluation of his pre- and postoperative facial photographs revealed no evidence of saddle nose, and the effects of the augmentation rhinoplasty were well maintained even 15 years postoperatively. A caudal cartilaginous deviation of the nose was observed on the basal view. The external nose was soft to palpation, with good mobility of the nasal tip. The patient reported no symptoms of nasal obstruction.

　This case demonstrates that an augmentation rhinoplasty using autologous composite grafts and septal extension grafts can achieve satisfactory functional and morphological outcomes, even over a long-term (15-year) follow-up.