Augmentation of the nasal spine area with tissue bone matrix sponge.
OBJECTIVE
High-density tissue bone matrix (TBM) sponge is a homograft derived from human cadaver. It is reported to be osteoinductive. The objective of this paper is to measure the bone formation and cosmetic effect of TBM sponge implanted in the nasal spine area of patients undergoing rhinoplasty with retraction of this region and loss of nasal tip support.


METHODS
The study was designed as a prospective trial.


METHODS
Patients were selected from private facial cosmetic practice and from public otolaryngology practice.


METHODS
Six patients were selected who had retraction of the nasal spine area and loss of tip support.


METHODS
Patients had implantation of the TBM sponge in the nasal spine area either as a sole procedure or in conjunction with other rhinoplasty maneuvers.


METHODS
Palpation was used to assess position, size and consistency of the implant. Cosmetic effect was assessed by computer imaging, which was used to measure nasolabial angle and tip projection. Bone formation was assessed by computed tomography scanning.


RESULTS
The implant could be palpated in all six patients at 1 month postoperatively, but at 3 months was either smaller or could not be felt. Nasolabial angle and tip projection were improved in all patients initially, but 3 months following surgery this cosmetic improvement was maintained in only two patients. At 3 months, CT scanning showed no evidence of bone formation.


CONCLUSIONS
The TBM sponge was not found to be osteoinductive or permanent when implanted in the nasal spine area and therefore is not a good implant in that region.
Marcells
G N
GN
Department of Otolaryngology, University of Toronto, Ontario.
Ellis
D A
DA
D001857:Bone Matrix / Q000637:transplantation*; D003094:Collagen; D004954:Esthetics; D005612:Freeze Drying; D006801:Humans; D009666:Nose / Q000601:surgery*; D010012:Osteogenesis; D011446:Prospective Studies; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome
D003094:Collagen