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Safety of Using Tutoplast-Processed Fascia Lata in Rhinoplasty: A Systematic Review and Meta-Analysis
Khalid H Al-Sebeih1, Ebraheem Albazee2, Mahmoud A Alsakka1
1Department of Otorhinolaryngology and Facial Plastic Surgery, Lothan Hospital, Salmiya, Kuwait.
Objective:
To evaluate the safety profile of using tutoplast-processed fascia lata (TPFL) as a graft material in patients undergoing both primary and revision rhinoplasty.
Methods:
PubMed, CENTRAL, Scopus, Web of Science, and EMBASE were searched. Eligible studies were evaluated for bias using the National Institutes of Health (NIH) assessment tool for cohort studies. Our safety outcomes included the incidence of graft resorption, infection, graft displacement, dorsal irregularity, overcorrected dorsal augmentation, and revision rates. Data were pooled as event rate (%) with a 95% confidence interval (CI) using STATA software.
Results:
Nine studies, comprising 827 patients, were included. Eight studies were evaluated with a low risk of bias, and one study had a moderate risk of bias. The pooled proportion analysis demonstrated a low graft resorption rate (event rate = 2.64%, 95% CI [0.69%, 5.62%]), infection rate (event rate = 0.30%, 95% CI [0.02%, 0.83%]), dorsal irregularity rate (event rate = 0.96%, 95% CI [0.09%, 2.51%]), graft displacement rate (event rate = 0.45%, 95% CI [0.07%, 1.12%]), overcorrected dorsal augmentation rate (event rate = 1.29%, 95% CI [0.39%, 2.65%]), and revision rate (event rate = 3.99%, 95% CI [1.82%, 6.90%]).
Conclusion:
This meta-analysis of 827 patients demonstrated that TPFL has a favorable safety profile in both primary and revision rhinoplasty, with low complication and revision rates. TPFL, whether used alone or in combination with cartilage, is a viable graft option for dorsal augmentation and enhancing nasal dorsum contour.
Level Of Evidence I:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
