【 文献重点摘要 】
 

Background: The aim of this study was to evaluate freeze-dried cortical allograft bone for nasal dorsal augmentation. The 42-month report on 18 patients was published in 2009 in Plastic and Reconstructive Surgery with 89 percent success at level II evidence, and this article is the 10-year comprehensive review of 62 patients.

Methods: All grafts met standards recommended by the American Association of Tissue Banks, the U.S. Food and Drug Administration, and the Centers for Disease Control and Prevention. Objective evaluation of the persistence of graft volume was obtained by cephalometric radiography, cone beam volumetric computed tomography, and computed tomography at up to 10 years. Vascularization and incorporation of new bone elements within the grafts were demonstrated by fluorine-18 sodium fluoride positron emission tomography at up to 10 years. Subjective estimation of graft volume persisting up to 10 years was obtained by patient response to a query conducted by an independent surveyor.

Results: The authors report objective proof of persistence of volume alone or combined with proof of neovascularization in 16 of 19 allografts. The authors report the patient’s subjective opinion of volume persistence in 37 of 43 grafts. The dorsal augmentation was assessed overall to be successful in 85 percent of 62 patients evaluated between 1 and 10 years, with a mean of 4.7 years.

Conclusions: Freeze-dried allograft bone is a safe and equal alternative for dorsal augmentation without donor-site morbidity. Further studies are needed to (1) confirm these findings for young patients needing long-term reconstruction, and (2) partially demineralize allograft bone to allow carving with a scalpel.

背景：本研究的目的是评价冷冻干燥同种异体皮质骨在鼻背隆起术中的应用。这份针对18名患者的42个月报告发表于2009年的整形和重建外科，二级证据成功率为89%，这篇文章是对62名患者的10年全面回顾。

方法：所有移植物都符合美国组织银行协会、美国食品和药物管理局以及疾病控制和预防中心推荐的标准。目的通过头影测量、锥束容积CT和CT对移植物体积的持久性进行评估，最长可达10年。长达10年的氟-18氟化钠正电子发射断层扫描证实了移植物内的血管化和新的骨元素的结合。对持续10年的移植物体积的主观估计是通过患者对独立调查员进行的询问的响应而获得的。

结果：作者报告了19例同种异体移植物中16例单独或结合新生血管证实体积持续存在的客观证据。作者报告了43例移植物中37例患者对容量持续性的主观看法。在62名患者中，有85%的患者在1-10年期间被评估为背部增强手术总体上是成功的，平均为4.7年。

结论：冻干同种异体骨是一种安全、平等的背部增强选择，无供体部位并发症。还需要进一步的研究来(1)证实这些结果适用于需要长期重建的年轻患者，以及(2)部分脱钙同种异体骨以允许用手术刀雕刻。