Aiding apparatus for nasal cartilage strut in nasal tip surgery

An aiding apparatus for nasal tip plasty is useable in augmentation rhinoplasty. The aiding apparatus for nasal tip plasty includes a strut part and a holding part provided on a lower portion of the strut part and coupled to septal cartilage. Thus, a cartilage scaffold complex useable in nasal tip plasty may be easily prepared at the exterior of an operation space. This aiding apparatus allows substitution for the paired batten graft or paired spreader graft and easier execution of caudal septal extension graft. Further, a decreased amount of cartilage is used to execute the nasal tip plasty in a simple way, therefore easily making a pretty nose, in addition to shortening the operation time.

TECHNICAL FIELD

The present invention relates, in general, to an aiding apparatus for nasal tip plasty, which is performed to elevate the nose and, more particularly, to an aiding apparatus for nasal tip plasty, which allows easy. fabrication of a cartilage scaffold complex used in nasal tip plasty outside an operation space, substitutes for the paired batten graft or the paired spreader graft, and allows easy operation of the caudal septal extension graft.

BACKGROUND ART

As alloplastic materials used in nasal tip plasty, medical silicone (dimethylsiloxane polymer) which is widely known to those skilled in the art, is mainly used. Further, Gore-Tex, polyethylene terephthalate, Proplast I and II (Medpore™), etc. are used as the alloplastic materials. Meanwhile, as natural materials, autologous cartilage is used in augmentation rhinoplasty.

Such alloplastic materials are of limited use when highly elevating a nasal tip.

It is because the elevation of a nasal tip using alloplastic materials (mainly silicone implants) interferes with the blood supply to the tip of the nose, thus causing the nasal tip to become red. Further, it has been reported that the alloplastic materials frequently penetrate the nasal tip.

For these reasons, when a nasal tip must be very highly elevated, autologous cartilage is commonly used.

Since autologous cartilage can make a much more beautiful nasal tip in the augmentation rhinoplasty, in comparison with silicone, plastic surgeons prefer autologous cartilage to silicone in the nasal tip plasty.

In the case of using autologous cartilage, ear cartilage or septal cartilage is mainly used, as shown inFIGS. 15 and 17. However, an operation using the autologous cartilage has a drawback in that more effort and time are required, compared to an operation using a silicone implant.

Nasal tip plasty using autologous cartilage is performed as follows.

Generally, a silicone implant or Gore-Tex is used for the dorsum (or, ridge) of the nose. Nasal tip plasty using autologous cartilage is performed on a nasal tip.

When the nose being subjected to augmentation rhinoplasty is cut open, as shown inFIG. 16, the nasal ridge (nasal vault) is divided into a cartilaginous vault and a bony vault.

As shown inFIGS. 16 and 17, the cartilaginous vault includes upper lateral cartilage and septal cartilage.

When viewing the upper lateral cartilage from the front, the upper lateral cartilage has a triangular shape and is firmly coupled to a nasal bone. This becomes the foundation of the nose, and includes the upper lateral cartilage, the nasal bone, the septal cartilage, and a perpendicular plate of the ethmoid bone.

Meanwhile, as shown inFIGS. 18 and 19, the lower lateral cartilage is divided into medial crura, middle crura, and lateral crura. A tip defining point (TDP) is defined by the vaults of the middle crura, a supratip breakpoint, and an infratip breakpoint. When viewing the lower lateral cartilage from the front, the lower lateral cartilage is seen to have a diamond shape (seeFIG. 20).

The nasal tip includes the lower lateral cartilage. The shape of the nasal tip is mainly determined by the shape and structure of the lower lateral cartilage (seeFIG. 19).

The work of harvesting the cartilage is conducted by harvesting some ear cartilage or septal cartilage, as shown inFIGS. 15 and 17.

When nasal tip plasty is performed after the cartilage is harvested, the cartilage is divided into several pieces, according to the intended purpose.

First, as shown inFIGS. 21 to 23, a strut is made of the cartilage and then is set up on the columellar.

When the medial crura of the lower lateral cartilage are secured to the strut, tension sufficient to elevate the nasal tip is created. In this state, cap grafting (seeFIG. 23) or shield grafting (seeFIG. 22) is performed, thus forming the nose into an intended shape.

When the strut is set up the strut is frequently connected to an upper border of the septal cartilage or the anterior nasal spine (seeFIG. 21). The upper border is a region of a nose defined from the dorsum to the anterior nasal spine. Especially when the strut is held on the upper border of the septal cartilage, the parts must be stitched to each other one by one in a narrow space, which takes a long time.

Further, this method is problematic in that the cartilage is apt to warp or be deformed, so that it is difficult to make an intended shape. To solve this problem, there is used the paired batten graft for doubly placing cartilage to the septal cartilage in a columellar direction or the paired spreader graft for doubly placing cartilage to the septal cartilage in a cephalo-caudal direction. However, this method consumes more cartilage and increases time taken for operation.

SUMMARY OF DISCLOSURE

Accordingly, the present invention has been made keeping in mind the above problems occurring in the prior art, and an object of the present invention is to provide an aiding apparatus for nasal tip plasty, in which a structure such as frame and scaffold using a non-toxic material is provided, and a cartilage scaffold complex used in cap grafting or shield grafting is manufactured from the exterior with minimal use of cartilage, so that the cartilage scaffold complex can be easily held on the upper border of the septal cartilage in a narrow surgical view, and thus a nasal tip having an intended shape can be obtained within a short period of time.

Another object of the present invention is to provide various methods, in which a scaffold serving as a support and providing a standard frame is made of biodegradable plastics, autologous cartilage is placed in the scaffold, and then the scaffold is biodegraded to disappear, thus minimizing the sensation of foreign body.

Still another object of the present invention is to provide an aiding apparatus for nasal tip plasty, which may substitute for the paired batten graft or the paired spreader graft and allow easy operation of caudal septal extension graft.

In order to accomplish the above objects, the present invention provides an aiding apparatus for nasal tip plasty, which includes a strut part; and a holding part provided on a lower portion of the strut part and coupled to septal cartilage.

Preferably, the holding part is coupled to an upper border of the septal cartilage. As an example, the holding part is secured to an upper border of the septal cartilage in a columellar direction. As another example, the holding part is secured to an upper border of the septal cartilage in a cephalo-caudal direction. Selectively, a seating part may be formed in the strut part, and an extension graft cartilage may be secured to the seating part.

In one aspect of the present invention, a ceiling part may be formed a top of the strut part such that cartilage for cap grafting is held thereon.

In another aspect of the present invention, a seating part may be formed on the strut part such that cartilage strut is seated therein. In this case, a sensation of foreign body may be decreased.

Preferably, the holding part may have a leg part which is coupled to the septal cartilage. Selectively, the leg part may have serrated parts on inner surfaces at both sides thereof. The serrated parts play a role of securing the leg part to the septal cartilage by engagement without stitching, thereby increasing the easiness of nasal tip plasty within a narrow operation space.

In still another aspect of the present invention, the strut part and the holding part may include a first unit and a second unit, which are separative from each other, and a coupling part for coupling the first unit and the second unit with each other. In this case, a seating part is preferably formed at an upper side of the coupling part such that cartilage strut is inserted therein, and a leg part is preferably formed at a lower side of the coupling part such that the leg part is secured to the septal cartilage.

Preferably, stitching holes are formed in the strut part, the holding part and a ceiling part.

If the aiding apparatus for nasal tip plasty according to the present invention is used for nasal tip plasty, a cartilage scaffold complex allowing cap graft or shield graft may be prepared at the outside with a minimal amount of cartilage and then easily secured to an upper border of septal cartilage within a narrow operation visual field, so nasal tip plasty may be executed within a very short time into an intended shape. Also, the present invention may substitute for the paired batten graft or paired spreader graft using autologous cartilage and also facilitate caudal septal extension graft.

DESCRIPTION OF REFERENCE CHARACTERS OF IMPORTANT PARTS

DETAILED DESCRIPTION OF DISCLOSURE

First Embodiment

FIG. 1is an exploded perspective view showing the first cartilage scaffold complex1using the first aiding apparatus for nasal tip plasty, according to the first embodiment of the present invention, andFIG. 2is a view showing the state in which the first cartilage scaffold complex1is secured to the upper border of septal cartilage.

As shown inFIGS. 1 and 2, the aiding apparatus10for nasal tip plasty according to the first embodiment of the present invention includes a strut part11and a holding part13.

Based on clinical tests, a material which is capable of minimizing known medical side effects, including interference with the blood supply to a nasal tip or allergies, is selected for the aiding apparatus10.

Preferably, the selected material is a non-toxic and biocompatible non-absorbable polymer or a non-toxic and biocompatible biodegradable polymer.

The strut part11serves as a columellar support for the elevation of the nasal tip.

Further, the strut part11functions as a support part for shield graft cartilage SG.

The shield graft cartilage SG is commonly used in the elevation of the nasal tip. At this time, the shield graft cartilage SG is the important part that determines the final shape of the nasal tip. To make the shield graft cartilage, the nasal septal cartilage is the most preferred material. However, other cartilages may be used to make the shield. A cartilage harvested and carved to have the shape of a shield so that both sides of the cartilage define the tip defining point (TDP). Preferably, the upper portion of the shield graft cartilage SG has a width from about 6 to 8 mm.

Stitching holes12are formed in the strut part11so as to fasten the shield graft cartilage SG to the strut part. Thus, the shield graft cartilage SG is fastened to the strut part11using a stitching suture.

As an alternative, a biodegradable pushpin may be used in place of the stitching suture to fix the shield graft cartilage SG. In the following explanation, all cartilages are fixed using switching sutures or biodegradable pushpins without any special mention.

The holding part13includes leg parts13aand13b, with a support groove13cdefined between the leg parts.

Such a construction allows the support groove13cbetween the leg parts13aand13bto be easily inserted into the upper border of the nasal septal cartilage SC, thus allowing an operation to be performed within a short period of time.

Stitching holes14are formed in the leg parts13aand13b, similarly to the strut part11. Thus, the nasal septal cartilage SC can be firmly fastened to the leg parts31a,31busing stitching sutures (shown by the dotted lines) to firmly fix the cartilage scaffold complex1to the septal cartilage SC.

The cartilage scaffold complex means a combination of a grafting cartilage and the aiding apparatus for nasal tip plasty, as disclosed in this embodiment and following embodiments. The grafting cartilage is obtained by carving autologous cartilage, harvested from a human body, as desired. The grafting cartilage includes struts, shield grafts, cap grafts, onlay cap grafts and extension grafts.

A ceiling part15is provided on the top of the strut part11.

Cap graft cartilage CG for cap grafting is placed on the ceiling part15.

The cap graft cartilage CG is the part that determines a final shape of the nasal tip. For using the cap graft cartilage CG, the nasal septal cartilage or ear cartilage is carved into several sheets with a width from about 6 to 8 mm to express the tip define point (TDP), and then the several sheets of carved cartilage are stacked to obtain a desired height. When the nasal septal cartilage or ear cartilage is stacked several times, it is required that the cartilage be firmly supported by a strong prop. The strut part11according to the first embodiment of this invention can more firmly support the cap graft cartilage CG with many folds, compared to the autologous cartilage.

Stitching holes16are formed in the ceiling part15, thus securely supporting the cap graft cartilage CG through stitching. Of course, when stitching and securing the cap graft cartilage, a pushpin may be used in place of stitching suture.

The ceiling part15is connected to the middle crura of lower lateral cartilage through the stitching holes16by using stitching sutures.

In order to meet the convenience of manufacture or to facilitate height adjustment, the upper end of the strut part11may substitute for the ceiling part15. In other words, the ceiling part15may not be formed at the upper portion of the strut part11as in the following embodiment.

As such, the shield graft cartilage SG and the cap graft cartilage CG are fastened to the strut part11and the ceiling part15of the cartilage scaffold complex1from the exterior. In this state, the cartilage scaffold complex is easily secured to the upper border of the septal cartilage SC. Therefore, it is not necessary to set up a strut using cartilage within a narrow surgical view, so that the time spent on an operation is reduced. Further, the amount of cartilage to be used is considerably reduced, thus alleviating a patient's pain, and allowing the patient to rapidly recover, in addition to more easily making a nose beautifully.

According to the condition of the elevation of the nasal tip, both the cap graft cartilage CG and the shield graft cartilage SG may be fastened to the cartilage scaffold complex. Either the cap graft cartilage or the shield graft cartilage may be fastened to the cartilage scaffold complex. In the case of fastening only the shield graft cartilage SG, the aiding apparatus10needs no ceiling part15.

Second Embodiment

FIG. 3is an exploded perspective view showing the second cartilage scaffold complex3using the second aiding apparatus for nasal tip plasty, according to the second embodiment of the present invention, andFIG. 4is a view showing the state in which the second cartilage scaffold complex3is secured to the upper border of septal cartilage.

As shown inFIGS. 3 and 4, the aiding apparatus30according to the second embodiment is similar in construction and function to the aiding apparatus10according to the first embodiment. However, unlike the first embodiment, serrated parts34aand34bare formed on the inner surfaces of leg parts33aand33b.

That is, the serrated parts34aand34bengage with each other, so that septal cartilage SC is held between the serrated parts. Thus, the cartilage scaffold complex3can be rapidly held to the upper border of the septal cartilage in a narrow operation space without the stitching operation.

Further, the aiding apparatus30includes stitching holes32which are formed in a strut part31, and stitching holes36which are formed in a ceiling part35. Thus, the cap graft cartilage CG or the shield graft cartilage SG may be stitched or connected by passing a stitching suture through the stitching holes or inserting push pins into the stitching holes. Thereby, a cartilage scaffold complex3is achieved.

Third Embodiment

FIG. 5is an exploded perspective view showing the third cartilage scaffold complex5using the third aiding apparatus for nasal tip plasty, according to the third embodiment of the present invention, andFIG. 6is a view showing the state in which the third cartilage scaffold complex5is secured to the upper border of septal cartilage.

As shown inFIGS. 5 and 6, the aiding apparatus50of the third embodiment is different from the aiding apparatuses of the first and second embodiments in that a seating part51ais provided in a strut part51so that a cartilage strut ST is seated in the seating part, and the aiding apparatus50is made of a biodegradable polymer material.

In detail, the aiding apparatus50serves as a scaffold which is decomposed and disappears after a predetermined period of time has passed.

One coupling hole52or a plurality of coupling holes52is formed in the seating part51aso as to support the cartilage strut ST which is seated in the seating part. The cartilage strut ST is fastened to the seating part51ausing a stitching suture.

While the cartilage strut ST is supported and grows in the seating part51a, the cartilage strut forms an intended shape within a few months. At this time, the aiding apparatus50is decomposed and disappears. Thus, it is possible to minimize the sensation of foreign body, and achieve a more natural cartilage structure.

Further, stitching holes52,54, and56are formed in the aiding apparatus50, so it is possible to secure the cap graft cartilage CG to the ceiling part35or secure a leg part53to the upper border of the septal cartilage by passing a stitching suture through the stitching holes or inserting push pins into the stitching holes.

Various medical instruments using biodegradable polymer materials have been used in a medical field. The biodegradable polymer materials include absorbable stitching sutures, osteocement for curing fractures, biological glue, a drug delivery system (DDS), and others. As bone conjugation plates or screws, StarScrew (Bionix, Inc.), BioScrew (Linvatec, Inc.), etc. have been developed. Recently, plastic surgeons have used an auxiliary material (Endotine™ Coapt systems, Inc.) for facelifts and browlifts.

In order to implant a biodegradable polymer material into the body, the material must have biodegradability and biocompatibility. Further, the material must be sterilizable, in addition to being easily manipulable. Furthermore, degradation products must not be toxic. Moreover, the biodegradable polymer material must decompose at a proper speed according to the intended purpose, and must maintain proper mechanical strength.

Since many biodegradable polymer materials satisfy the above-mentioned requirements, they are used as a medical material. Among the biodegradable polymer materials, polylactic acid (PLLA), polyglycolic acid (PGA), polylactic acid-co-glycolic acid (PLGA copolymer), polyhydroxyalkanoate (PHA), polyhydroxybutyrate (PHB), and polycaprolactone (PCL) have proper mechanical strength, biocompatibility, biodegradability, and processability. For these reasons, the above-mentioned materials may be used as preferred biodegradable polymer materials of the present invention.

Generally, medical material using PGA loses mechanical strength after 4 to 8 weeks have passed. It takes 3 to 6 months to decompose PLLA. Thus, a proper material must be selected in consideration of the decomposition period.

Fourth Embodiment

FIG. 7is a perspective view showing the fourth aiding apparatus for nasal tip plasty according to the fourth embodiment of the present invention.

The aiding apparatus60according to the fourth embodiment allows substituting for the paired batten graft or the paired spreader graft using autologous cartilage at the nasal tip plasty. The aiding apparatus60of the fourth embodiment is substantially identical to that of the third embodiment, except that no ceiling part is provided thereto. InFIG. 7, the aiding apparatus60is illustrated such that the leg part53is located at an upper portion, and the strut part51is located at a lower portion.

The aiding apparatus60may be secured to the septal cartilage SC as shown inFIG. 13. In other words, a support groove53cformed in the leg part53of the aiding apparatus60is inserted into the upper border of the septal cartilage SC in a cephalo-caudal direction, and the leg part53is secured to the septal cartilage using stitching sutures or push pins. In this way, the paired spreader graft using autologous cartilage may be substituted.

Also, as required, the extension graft cartilage EG may be secured to the seating part51aprovided at the strut part51by using stitching sutures or push pins, which may substitute for the caudal septal extension graft.

Further, as required, onlay cap graft OCG may be secured to an upper portion of the extension graft cartilage EG to make a nasal tip into an intended shape, as shown inFIGS. 8 and 14.

In the conventional caudal septal extension graft, the harvested and carved cartilage is doubly placed to the septal cartilage SC to perform the paired spreader graft, and then the extension graft cartilage EG is inserted between the placed cartilages. Thus, cartilage is consumed as much as the placed cartilages are used. Also, as indicated by the reference symbol A inFIG. 26, the extension graft cartilage EG may be secured in a distorted direction with respect to the nasal central direction when the extension graft cartilage EG is stitched, which may causes the nasal shape not to be accurately symmetrical after operating the nasal tip plasty.

However, if the caudal septal extension graft is operated using the aiding apparatus60according to the fourth embodiment of the present invention, the operation may be performed easily only with two-stage processes: namely inserting the support groove53cof the leg part53into the upper border of the septal cartilage SC and securing the leg parts53by means of stitching sutures or push pins, and then securing the extension graft cartilage EG to the seating part51aprovided at the strut part51by means of stitching sutures or push pins. Thus, an amount of consumed cartilage is decreased rather than the conventional operation method, and also the possibility of side effects causing distorted nasal shape may be greatly decreased.

Fifth Embodiment

FIGS. 9 and 10are an exploded perspective view and a front view, respectively, showing the fifth aiding apparatus for nasal tip plasty according to the fifth embodiment of the present invention.

The aiding apparatus70according to the fifth embodiment includes a first unit70aand a second unit70bwhich are made of a biodegradable polymer material, and coupling parts77aand77bwhich function to couple the first and second units70aand70bto each other.

The first unit70aincludes a first strut part71aand a leg part73a, and the second unit70bincludes a second strut part71band a leg part73b. The coupling parts77aand77bcomprise a first coupling unit77aand a second coupling unit77b.

Further, if necessary, a first ceiling part75aand a second ceiling part75bare provided, respectively, on the top of the first strut part71aand the top of the second strut part71b.

The first coupling part77acomprises a coupling protrusion77a, while the second coupling part77bcomprises a coupling hole77b.

When the coupling protrusion77ais fitted into the coupling hole77b, a seating part71cis provided above the coupling parts, so that cartilage strut ST is seated in the seating part. A support groove73cis formed under the coupling parts, so that the upper border of septal cartilage SC is supported in the support groove. It would be apparent to those having ordinary skill in the art that the coupling part may be modified in various ways other than the coupling protrusion77aand the coupling hole77b.

The coupling protrusion77ais provided on a base part78. The base part78supports the cartilage strut ST, and defines a predetermined interval between the first and second strut parts71aand71b.

Further, stitching holes72a,74a, and76aare formed in the first unit70a, and stitching holes72b,74b, and76bare formed in the second unit70b. The cartilage strut ST, the cap graft cartilage CG or the septal cartilage may be stitched or connected by passing a stitching suture through the stitching holes or inserting push pins into the stitching holes.

Sixth Embodiment

FIGS. 11 and 12are, respectively, an exploded perspective view and a front view showing the sixth aiding apparatus for nasal tip plasty according to the sixth embodiment of the present invention.

The aiding apparatus80according to the sixth embodiment is substantially identical to that of the fifth embodiment, except that there is not provided the first ceiling part75aand the second ceiling part75b.

The aiding apparatus80according to the sixth embodiment may be used in the same way as that of the fourth embodiment. When the aiding apparatus80is used for nasal tip plasty, the coupling protrusion77ais inserted into the coupling hole77bto couple the first unit70aand the second unit70bwith each other before the operation. Then, the seating part71cis formed at the upper side of the aiding apparatus80, and the support groove73cis formed in the lower side thereof. The support groove73cmay be secured to the septal cartilage SC in a cephalo-caudal direction or a columellar direction of the septal cartilage, and the cartilage strut ST or the extension graft cartilage EG may be secured to the seating part71c. If the support groove73cis secured in a columellar direction, the cartilage strut ST may be supported. Also, if the support groove73cis fixed in a cephalo-caudal direction, the extension graft cartilage EG may be supported.

As described above, an aiding apparatus for nasal tip plasty according to the present invention has the following effects.

When the essential process of the nasal tip plasty is performed, that is, a cartilage strut is formed, cap grafting and shield grafting can be performed from the exterior of the operation space, thus allowing a cartilage scaffold complex to be more easily manufactured. Also, the cartilage scaffold complex may be easily held on the upper border of the septal cartilage. Thus, the present invention is advantageous in that only a minimum amount of cartilage is required, the operation period is shortened, a patient's pain is alleviated, and recovery after the operation is fast, thus allowing a beautiful nose to be more easily made.

A ceiling part is provided on the top of a strut part, so that cartilage for cap grafting can be stably held on the strut.

Further, since the strut part and the holding part are made of a degradable polymer material which is absorbable and decomposed after a predetermined period of time has passed, and a seating part is provided on the strut part so that the cartilage strut is seated on the seating part, the sensation of foreign body can be minimized.

Furthermore, the holding part includes leg parts, between which septal cartilage is inserted, and serrated parts are provided on the inner surfaces of the leg parts. Thus, the septal cartilage is secured to the holding part not by stitching using a stitching suture but by the engagement of the serrated parts, so that it is easy to apply the aiding apparatus of this invention in a narrow operation space.

In addition, if the aiding apparatus for nasal tip plasty with no ceiling part is used, there is no need to execute the paired batten graft or the paired spreader graft using autologous cartilage, which may decrease an amount of cartilage used. Also, the extension graft cartilage EG may be easily secured, which may minimize a side effect causing a distorted nasal space after the nasal tip plasty.