Study On Imaging Measurement Of Costal Cartilage Associated With Rhinoplasty In Female

Background:Nose is one of the most prominent parts of the human face,so it attracts people's attention and affects people's appearance.Therefore,rhinoplasty has gradually become one of the most popular cosmetic surgery,and the scope of this treatment also extends from various congenital or traumatic nasal deformity correction to various types of nasal cosmetic reshaping.However,the Asian nose is characterized by a low level of nose root,a wider nasal dorsum,a blunt nasal tip,the soft tissue and thin cartilage,which poses a great challenge to the rhinoplasty in Chinese.Because of the anatomical and racial differences,most Asian rhinoplasty targets are different from those of the Caucasian,their nasal dorsa and tips are more likely to be raised.The current opinion on rhinoplasty emphasizes on using an autologous tissue.The costal cartilage is an important source of autogenous tissue material commonly used in rhinoplasty.However,there are still some problems related to the selection of costal cartilage waiting for a solution.For instance: whether the size of the costal cartilage is suitable for rhinoplasty,whether calcification is serious;what kind of difficulties may be faced in operation,which rib is the most suitable sauce for rhinoplasty,the sixth,seventh or eighth rib;how the vessels surrounding the costal cartilage are distributed;how we could use the smallest incision to obtain the most materials,at the same time avoid risk.To make some contribution to solving the above problems,this study tries to measure the three-dimensional data of costal cartilages(18 years old-45 years old)for the rhinoplasty in East China.Objective:1.To describe the three-dimensional data of the costal cartilage(18 years old-45 years old)in East China,explore the regularity of costal cartilage development and calcification,provide a reference for the design of autogenous costal cartilage rhinoplasty,and assist the preoperative surgical incision design and the construction of the nasal cartilage scaffold.2.To describe the relationship between the internal thoracic artery and costal cartilage through enhanced imaging and three-dimensional reconstruction of the thoracic vessels,and provide evidence for efficient and safe intercostal cartilage extraction.Result:1.Three-dimensional size database of 6th,7th and 8th costal cartilage in rhinoplastyaged women in East China were obtained.These data show the 7th costal cartilage had the longest straight length and maximum thickness,while the 6th costal cartilage had the best flatness and width while having the smallest coefficient of variation and good stability.The 8th costal cartilage shown no advantage when compared to other two costal cartilages on the above parameters.2.There was no significant difference between the left and right costal cartilage in most indexes based on the size data.There was no significant difference in calcification between the sixth,seventh,eighth costal cartilage.Calcification was associated with age,but their correlation was weak.It is difficult to predict calcification of specific costal cartilage based on the age of patients.Therefore,to comprehensively evaluate the costal cartilage,CT examination was recommended.3.The internal thoracic artery originates from both sides of the subclavian artery and follows the cartilage.The 6th intercostal space(between the 6th to the 7th costal cartilage)branches to the diaphragmatic artery and superior epigastric artery and the inferior epigastric artery runs downward.The diaphragmatic muscles run outward from the 6th intercostal spaces.The position of the branch point of the blood vessel is relatively regular,and it is located in the 6th intercostal space,which is about 2-3cm from the midline of the human body.Conclusion:1.CT examination and three-dimensional reconstruction can well assess the development and calcification of costal cartilage with high accuracy.2.The 6thand 7th costal cartilage can be used for costal cartilage rhinoplasty.The 6th costal cartilage ribs are short and straight,with good stability,excellent concealment,the 7th costal cartilage is long,slight and thick,shows better dissection safety.3.Adequate preoperative imaging evaluation is needed for every patient,because it is difficult to predict calcification of specific costal cartilage based on the age of patients.4.The risk line for the cartilage dissection located at 2-3cm from the midline of human body,and the surgeon should avoid blind intercepting to avoid damaging the internal thoracic artery and its branches.