- 期刊
Nasal Alar Necrosis after Calcium Hydroxylapatite Injection-＂A Case Report and Literature Review＂
皮膚填充物注射後鼻翼壞死－病例報告及文獻回顧
摘要
背 景：各種軟組織填充物已被廣泛用於當今許多微整形手術；鈣羥基磷灰石和玻尿酸為合成填料，可用於改善中度至重度面部皺紋、褶皺。然而，一些併發症不可避免地發生，從輕度的灼熱感到令人不能接受的致死性中風。在這份報告中，我們提出了一個病人接受以鈣羥基磷灰石注射隆鼻，而導致右鼻翼全層壞死，最後以鼻唇溝皮瓣與複合移植物重建。目的及目標：在此我們提出一個罕見病例，並檢討鈣羥基磷灰石注射繼發皮膚壞死及探討文獻。材料及方法：這是一個健康的43歲女性患者。三年前她接受以鈣羥基磷灰石注射隆鼻。然而，在注射後立即在注射部感受到不能忍受的疼痛。幾個小時後，右側鼻翼轉變成黑色。因此，她來到我們整形外科門診尋求幫助。經過數個月的保守治療後，雖然壞死皮膚脫落，但瘢痕攣縮且鼻輪廓改變。與病人討論後，我們施以鼻唇溝皮瓣及複合軟骨移植手術來重建右鼻翼輪廓。結 果：在釋放攣縮組織後，以鼻唇溝皮瓣及複合軟骨移植重建右鼻翼。手術後，患者有一個相對正常的外形和良好的外觀。結 論：根據文獻綜述，在填充劑注射後一些不可接受或是致死性的併發症是罕見的，但確實會發生。我們應該在使用這些填料時，需要保持高度的警覺心；如果不幸地發生併發症時，應按照以往文獻的建議立即來治療這些併發症。此外，鼻翼癒合後產生瘢痕攣縮，需要的鼻重建措施是相對困難的，需要有經驗的醫生來執進行。謹慎預防是解決這些併發症的最好辦法。
關鍵字
無資料並列摘要
Background: Various soft tissue fillers have found wide application in many cosmetic procedures. A calcium hydroxylapatite and polysaccharide gel is considered a synthetic filler suitable for the correction of moderate to severe facial wrinkles and folds and soft tissue augmentation. However, some unacceptable complications can occur following calcium hydroxylapatite injection. Aim and Objectives: To report a case of right nasal alar necrosis after calcium hydroxylapatite injection during rhinoplasty. Materials and Methods: A 43-year-old woman in relatively good health underwent a calcium hydroxylapatite dermal filler injection during rhinoplasty at a cosmetic clinic. However, she experienced severe pain immediately thereafter and observed blackening of the skin over the right nasal ala after several hours. The patient approached our plastic surgery outpatient clinic for help. After conservative treatment, the necrotic skin sloughed off, but the scar contracture caused a deformed nasal contour. Therefore, a two-stage nasal reconstruction, consisting of a nasolabial flap and a composite cartilage graft, was under taken to rebuild the right nasal ala. Results: After surgical correction, the patient had relatively normal and satisfactory contour and appearance of the right nasal ala. Conclusion: In the published literature, devastating complications following injection of dermal fillers, although rare, have been reported. These fillers should be used with extreme caution and in accordance with the protocols suggested for the prevention and treatment of complications.