Ultrasound visualization of augmentation rhinoplasty using diced cartilage framework: A pictorial study

Area of Science:

• Plastic Surgery
• Regenerative Medicine
• Medical Imaging

Background:

• Diced cartilage (DC) is crucial for nasal dorsal augmentation in rhinoplasty, forming diced cartilage framework (DCF).
• Understanding the in vivo viability and integration of DCF is essential for successful outcomes.

Purpose of the Study:

• To evaluate the efficacy of high-resolution ultrasound in visualizing diced cartilage framework (DCF) in augmentation rhinoplasty.
• To assess the in vivo viability, structural integrity, and neovascularization of DCF over a one-year postoperative period.

Main Methods:

• Fifteen patients undergoing nasal dorsal augmentation with two types of DCF (wrapped in fascia lata/Lyomesh® or embedded in platelet-rich fibrin) were studied.
• High-frequency ultrasound and color Doppler imaging were used for postoperative follow-ups at one month, three months, and one year.
• Ultrasound parameters assessed included DCF visualization, integrity, edema, and neovascularization.

Main Results:

• Ultrasound successfully depicted DCF in all patients, appearing as hypoechoic, inhomogeneous areas.
• The DCF remained largely intact with minimal diameter reduction and no migration over one year; perifocal edema significantly decreased.
• DC wrapped in fascia lata/Lyomesh® showed a distinct hyperechoic envelope, while DC in PRF spread laterally. Neovascularization was identified in 7 of 15 patients via color Doppler.

Conclusions:

• High-resolution ultrasound is an accurate, non-invasive method for visualizing DCF in augmentation rhinoplasty.
• Ultrasound allows for assessment of DCF viability, structural stability, and early signs of neovascularization.