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EN
Introduction: We present a single surgeon’s experience of open augmentation rhinoplasty with autogenous
L-shaped costal cartilage grafts, with long-term patient-reported outcome data. We highlight the salient operative steps and outline the peri-operative care required to optimise outcomes. Materials and Methods: A retrospective review of eleven such augmentation rhinoplasties performed between 2008 and 2016 was undertaken. Indications included saddle nose deformity [granulomatosis with polyangiitis (n=7) and relapsing polychondritis (n=1)], post-traumatic nasal collapse (n=1) and advanced cosmetic westernisation of the nose (n=2). Long-term patient-reported outcome was assessed with a patient questionnaire. Results: All patients achieved marked improvement in nasal position, shape and function. There was no cartilage exposure, warping or resorption and no recurrent deformities. One patient’s dorsal graft was fractured two years later during an ophthalmological procedure and the deformity was re-corrected successfully, again with the above technique. Average follow up was 5.2 years. Of the nine patients who responded to the follow-up questionnaire, 100% were satisfied with their nasal appearance. 100% of responders at follow-up reported that they have had no problems relating to their nose (n=9). Discussion: L-shaped costal cartilage grafts provided a reliable, reproducible approach in augmentation rhinoplasty for disparate indications (inflammatory, traumatic and cosmetic) in the hands of a low-volume operator. With careful patient selection and planning, this technique can provide pleasing aesthetic outcomes and high patient satisfaction, with good long-term outcomes.
EN
Introduction: We present a single surgeon’s experience of open augmentation rhinoplasty with autogenous
L-shaped costal cartilage grafts, with long-term patient-reported outcome data. We highlight the salient operative steps and outline the peri-operative care required to optimise outcomes. Materials and Methods: A retrospective review of eleven such augmentation rhinoplasties performed between 2008 and 2016 was undertaken. Indications included saddle nose deformity [granulomatosis with polyangiitis (n=7) and relapsing polychondritis (n=1)], post-traumatic nasal collapse (n=1) and advanced cosmetic westernisation of the nose (n=2). Long-term patient-reported outcome was assessed with a patient questionnaire. Results: All patients achieved marked improvement in nasal position, shape and function. There was no cartilage exposure, warping or resorption and no recurrent deformities. One patient’s dorsal graft was fractured two years later during an ophthalmological procedure and the deformity was re-corrected successfully, again with the above technique. Average follow up was 5.2 years. Of the nine patients who responded to the follow-up questionnaire, 100% were satisfied with their nasal appearance. 100% of responders at follow-up reported that they have had no problems relating to their nose (n=9). Discussion: L-shaped costal cartilage grafts provided a reliable, reproducible approach in augmentation rhinoplasty for disparate indications (inflammatory, traumatic and cosmetic) in the hands of a low-volume operator. With careful patient selection and planning, this technique can provide pleasing aesthetic outcomes and high patient satisfaction, with good long-term outcomes.
PL
Obwodowe wrzodziejące zapalenie rogówki jest stanem zapalnym, zwykle w kształcie półksiężyca, występującym w okolicy rąbka rogówki, gdzie zawsze wiąże się ze ścieńczeniem zrębu rogówki. Niejednokrotnie występuje w przebiegu chorób reumatoidalnych, natomiast najczęściej związane jest z reumatoidalnym zapaleniem stawów. Obwodowe wrzodziejące zapalenie rogówki obserwuje się także w: ziarniniakowatości z zapaleniem naczyń, guzkowatym zapaleniu tętnic, nawracającym zapaleniu chrząstek oraz w toczniu rumieniowatym układowym. Wymienione choroby opisano w odniesieniu do obwodowego wrzodziejącego zapalenia rogówki, z omówieniem poszczególnych metod leczenia w określonych przypadkach.
EN
Peripheral ulcerative keratitis is an inflammatory condition, usually crescent shaped and occurring in the corneal stromal region, where it is always associated with corneal stromal thinning. Peripheral ulcerative keratitis often occurs in the course of rheumatic diseases but is most commonly associated with rheumatoid arthritis. Peripheral ulcerative keratitis is also seen in granulomatosis with polyangiitis, polyarteritis nodosa, relapsing chondritis, and systemic lupus erythematosus. These diseases are analyzed in the article in relation to peripheral ulcerative keratitis with a discussion of individual treatment methods in specific cases.
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