Use of a fibrinogen-thrombin sponge (TachoSil®) in rhinoplasty: a systematic retrospective analysis

Introduction:

Several methods have been developed to address nasal dorsum augmentation and smoothing of irregularities in rhinoplasty. Finding the ideal method is still controversial. In this study we evaluate a novel technique of cartilage grafting for nasal dorsum augmentation by wrapping cartilage in a fibrinogen and thrombin coated collagen patch named TachoSil®.

Methods:

From 16.02.2007 – 11.02.2016, TachoSil® was applied in rhinoplasty in 141 patients. We retrospectively analysed clinical data and photo documentation collected during the postoperative follow-up visits. The mean follow-up period was 20 months.

Results:

In 141 patients, TachoSil® was used in different indications: augmentation of saddle nose deformities (n = 72), radix (n = 5), tip-area (n = 4) and refinement of nasal dorsum irregularities (n = 59). A diced cartilage graft enclosed by a bilayer of TachoSil® was applied in 83 patients. Solid pieces of cartilage were either embedded in a bilayer of TachoSil® (n = 14) or covered by a monolayer (n = 51), respectively. In 77 cases, septal cartilage was harvested, in 32 and 8 patients ear and rib cartilage, respectively. Moreover, TachoSil® without cartilage served as a soft tissue support in 16 thin skinned patient. One patient had a soft tissue infection of the nasal tip with a onset 3 weeks postoperatively, another develop bilateral edema of the cheek region on the first postoperative day. In both cases, conservative management was sufficient. A causal relation to TachoSil® could not be shown.

Conclusions:

TachoSil® is an eligible and comparatively safe method to facilitate diced or solid cartilage fixation in nasal dorsum augmentation and precise profile shaping.

Publication History

Publication Date:
18 April 2018 (online)