Mechanical analysis of the effects of cephalic trim on lower lateral cartilage stability.
Mechanical analysis of the effects of cephalic trim on lower lateral cartilage stability.
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DOI：
10.1001/archfacial.2011.1354
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发表时间：
2012-01
影响因子：
--
通讯作者：
Wong, Brian
中科院分区：
文献类型：
--
作者：
Oliaei, Sepehr;Manuel, Cyrus;Protsenko, Dmitriy;Hamamoto, Ashley;Chark, Davin;Wong, Brian
确定猪软骨鼻尖模型中不同程度的头颅切除后下外侧软骨 (LLC) 的机械稳定性如何变化。鼻翼软骨取自新鲜猪头盖骨 (n=14)，并进行切片以精确模拟人类 LLC 的大小和尺寸。在头颅修剪 0（对照）、4 和 6 毫米之前和之后均进行了弯曲力学分析。在 LLC 模型的 3 个位置（距中线 4、6 和 8 mm）进行悬臂变形测试，并测量积分反作用力。假设 LLC 模型的几何形状近似于修改后的单悬臂梁，计算脚的等效弹性模量。使用 3 维有限元模型对 3 种 LLC 宽度中每一种的规定载荷条件下的应力分布进行建模。 LLC 模型的等效弹性模量在最外侧点 8 毫米处出现统计显着下降 (P=0.02)，并且仅当支柱剩余 4 毫米时 (P=05)。有限元模型显示，当组织从中线弯曲 8 毫米时，最大的内应力位于鼻尖。我们的结果为建议的临床指南提供了机械基础，该指南指出，由于过度切除的 LLC 对覆盖皮肤软组织包膜的结构支撑不良，小于 6 毫米的残余支柱可能会导致美容效果不佳。
To determine how mechanical stability changes in the lower lateral cartilage (LLC) after varying degrees of cephalic resection in a porcine cartilage nasal tip model. Alar cartilage was harvested from fresh porcine crania (n=14) and sectioned to precisely emulate a human LLC in size and dimension. Flexural mechanical analysis was performed both before and after cephalic trims of 0 (control), 4, and 6 mm. Cantilever deformation tests were performed on the LLC models at 3 locations (4, 6, and 8 mm from the midline), and the integrated reaction force was measured. An equivalent elastic modulus of the crura was calculated assuming that the geometry of the LLC model approximated a modified single cantilever beam. A 3-dimensional finite element model was used to model the stress distribution of the prescribed loading conditions for each of the 3 types of LLC widths. A statistically significant decrease (P=.02) in the equivalent elastic modulus of the LLC model was noted at the most lateral point at 8 mm and only when 4 mm of the strut remained (P=05). The finite element model revealed that the greatest internal stresses was at the tip of the nose when tissue was flexed 8 mm from the midline. Our results provide the mechanical basis for suggested clinical guidelines stating that a residual strut of less than 6 mm can lead to suboptimal cosmetic results owing to poor structural support of the overlying skin soft-tissue envelope by an overly resected LLC.
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