Fibrinogen-Thrombin Coated Collagen Sponge (TachoSil®) Usage in Rhinoplasty: Our Experience

Abstract

Objective: There are multiple techniques to obtain a reasonable augmentation and filling of the nasal dorsum and ensure a smooth and harmonic nasal dorsum in rhinoplasty. This article will discuss our results of applying fibrinogen and thrombin coated collagen patch named TachoSil® in various rhinoplasties, with or without using an additional bone or cartilage graft. Methods: We retrospectively analyzed the preoperative and six months postoperative clinical data as well as the overall satisfaction of a total of 78 patients who were applied TachoSil® during their rhinoplasties between Jan 2016 and July 2019. Results: Rhinoplasties were all performed with a closed approach. No postoperative bleeding and no allergic reactions to TachoSil® were reported. Two patients presented on the 10th postoperative day with nasal dorsum abscess. 83% of the patients were satisfied, whereas nasal retouching was performed in 17% of patients because of dissatisfaction. Conclusion: In addition to its significant hemostatic role, TachoSil® is considered a safe, effective, and easy method to be applied for graft fixation in Augmentation rhinoplasties, to conceal the nasal dorsum irregularities, to fill and support soft tissue in patients with thin nasal skin.

Keywords

• Augmentation
• Rhinoplasty
• Autografts
• Cartilage
• Cosmetic techniques
• Hemostatic Technics

Kaynakça

1. 1. Harsha BC. Complications of rhinoplasty. Oral and maxillofacial surgery clinics of North America. 2009;21(1):81-9.
2. 2. Bakshi J, Patro SK. Septorhinoplasty: Our Experience. Indian J Otolaryngol Head Neck Surg. 2017;69(3):385-91.
3. 3. Daniel RK. Rhinoplasty: dorsal grafts and the designer dorsum. Clinics in plastic surgery. 2010;37(2):293-300.
4. 4. Balaji S. Costal cartilage nasal augmentation rhinoplasty: Study on warping. Annals of Maxillofacial Surgery. 2013;3(1):20-4.
5. 5. Patrocinio LG, Patrocinio TG, Patrocinio JA. Trending Topics in Rhinoplasty. Archives of Facial Plastic Surgery. 2011;13(6):434-5.
6. 6. Martin S, McBride M, Stewart R, McBride G, Hill C. Single centre review of the use of costal cartilage for reconstruction of the nasal dorsum. European Journal of Plastic Surgery. 2019:1-8.
7. 7. Cakmak O, Buyuklu F. Crushed cartilage grafts for concealing irregularities in rhinoplasty. Arch Facial Plast Surg. 2007;9(5):352-7.
8. 8. Daniel RK. Rhinoplasty: septal saddle nose deformity and composite reconstruction. Plastic and reconstructive surgery. 2007;119(3):1029-43.

9. 9. Robotti E. Shaping the nasal dorsum. Hno. 2018;66(2):92-102.
10. 10. Jang YJ, Song HM, Yoon YJ, Sykes JM. Combined use of crushed cartilage and processed fascia lata for dorsal augmentation in rhinoplasty for Asians. The Laryngoscope. 2009;119(6):1088-92.
11. 11. Yu MS, Park HS, Lee HJ, Jang YJ. Histomorphological changes of Tutoplast-processed fascia lata grafts in a rabbit rhinoplasty model. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. 2012;147(2):239-44.
12. 12. Tasman AJ, Diener PA, Litschel R. The diced cartilage glue graft for nasal augmentation. Morphometric evidence of longevity. JAMA facial plastic surgery. 2013;15(2):86-94.
13. 13. Mendelsohn M, Dunlop G. Gore-tex augmentation grafting in rhinoplasty--is it safe? The Journal of otolaryngology. 1998;27(6):337-41.
14. 14. Sajjadian A, Naghshineh N, Rubinstein R. Current status of grafts and implants in rhinoplasty: Part II. Homologous grafts and allogenic implants. Plastic and reconstructive surgery. 2010;125(3):99e-109e.
15. 15. Rickenbacher A, Breitenstein S, Lesurtel M, Frilling A. Efficacy of TachoSil a fibrin-based haemostat in different fields of surgery--a systematic review. Expert opinion on biological therapy. 2009;9(7):897-907.
16. 16. Berghaus A, San Nicoló M, Jacobi C. Use of a fibrinogen-thrombin sponge in rhinoplasty. Hno. 2018;66(2):103-10.
17. 17. Belli E, Rendine G, Mazzone N. Cold therapy in maxillofacial surgery. The Journal of craniofacial surgery. 2009;20(3):878-80.
18. 18. Hanci D, Üstün O, Kumral TL, Ahmed EA, Uyar Y. Camouflage of the Nasal Dorsum in Thin-Skinned Patients with Diced Cartilage Combined with a New Cross-Linked Hyaluronan (NCH) Gel and Blood: A New Method. Aesthetic plastic surgery. 2019;43(3):786-92.
19. 19. Guler I, Kum RO, Yilmaz YF. Application Of Platelet Rich Fibrin Matrix (PRFM) In Septorhinoplasty. ENT Updates. 2019;9(1):53-8.
20. 20. Heilbronn C, Cragun D, Wong BJ. Complications in rhinoplasty: A literature review and comparison with a survey of consent forms. Facial Plast Surg Aesthet Med. 2020;22(1):50-6.
21. 21. Sharif-Askary B, Carlson A, Van Noord M, Marcus J. Incidence of postoperative adverse events after rhinoplasty: A systematic review. Plastic Reconsctructive Surgery. 2020;145(3):669-84.