Subscribe to RSS
DOI: 10.1055/s-0033-1346999
Rhinoplasty Using Autologous Costal Cartilage
Publication History
Publication Date:
12 June 2013 (online)
Abstract
Most Latin American patients looking to have a primary septorhinoplasty share common characteristics in relation to an incorrect projection of the nasal tip complex and a low dorsal line. Thus, the frequent use of structural techniques and of surgical enhancement techniques becomes necessary to improve the nasal contour. In cases of secondary septorhinoplasty, it is also usual in our practice not to have sufficient septal cartilage available or with the required quality to give structure and support to the nasal tip complex, handle the nasal dorsum, and simultaneously correct postseptorhinoplasty deformities. For these reasons, in our practice costal cartilage represents an excellent option as autologous graft material. We present our experience using autologous costal cartilage for structural and nonstructural purposes in 286 selected patients who underwent open rhinoplasty between 2004 and 2011. We emphasize preoperative analyses, we discuss the criteria for selecting costal graft as graft material, we show key aspects of the dynamic of the surgery, and we consider the possibility of using autologous costal graft in combination with heterologous grafts. In this work we also establish the disadvantages of costal cartilage as graft material in specific areas of the surgical anatomy of the nose.
-
References
- 1 Artículo de la Enciclopedia Libre Universal en Español. Demographics of Venezuela. Available at: http://enciclopedia.us.es/index . Accessed September 17, 2012
- 2 Cobo R. Mestizo rhinoplasty. Facial Plast Surg 2003; 19: 257-268
- 3 Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 2004; 130: 157-163
- 4 Miranda N, Gil Larrocca C, Gómez T , et al. Caudal extender autologous cartilaginous graft for handling projection and rotation of the nasal tip in septorhinoplasty. Acta Otorrinolaringol 2007; 19: 74-81
- 5 Toriumi DM. Caudal septal extension graft for correction of the retracted columella. Oper Tech Otolaryngol--Head Neck Surg 1995; 6: 311-318
- 6 Aponte C, Miranda N, Gil Larocca C , et al. Management of the nasal tip in open rhinoplasty through the tongue-in-groove technique. Acta Otorrinolaringol 2006; 18: 68
- 7 Kridel RW, Scott BA, Foda HM. The tongue-in-groove technique in septorhinoplasty. A 10-year experience. Arch Facial Plast Surg 1999; 1: 246-256 , discussion 257–258
- 8 Sepehr A, Alexander AJ, Chauhan N, Chan H, Adamson PA. Cephalic positioning of the lateral crura: implications for nasal tip-plasty. Arch Facial Plast Surg 2010; 12: 379-384
- 9 Powell N, Humphrey B. Proportions of the Aesthetic Face. New York, NY: Thieme-Stratton; 1984: 82
- 10 Kim DW, Shah AR, Toriumi DM. Concentric and eccentric carved costal cartilage: a comparison of warping. Arch Facial Plast Surg 2006; 8: 42-46
- 11 Adams Jr WP, Rohrich RJ, Gunter JP, Clark CP, Robinson Jr JB. The rate of warping in irradiated and nonirradiated homograft rib cartilage: a controlled comparison and clinical implications. Plast Reconstr Surg 1999; 103: 265-270
- 12 Gunter JP, Clark CP, Friedman RM. Internal stabilization of autogenous rib cartilage grafts in rhinoplasty: a barrier to cartilage warping. Plast Reconstr Surg 1997; 100: 161-169
- 13 Sajjadian A, Naghshineh N, Rubinstein R. Current status of grafts and implants in rhinoplasty: Part II. Homologous grafts and allogenic implants. Plast Reconstr Surg 2010; 125: 99e-109e
- 14 Sykes JM, Patel KG. Use of Medpor implants in rhinoplasty surgery. Oper Tech Otolaryngol--Head Neck Surg 2008; 19: 273-277
- 15 Conrad K, Torgerson CS, Gillman GS. Applications of Gore-Tex implants in rhinoplasty reexamined after 17 years. Arch Facial Plast Surg 2008; 10: 224-231
- 16 Razmpa E, Saedi B, Mahbobi F. Augmentation rhinoplasty with combined use of Medpor graft and irradiated homograft rib cartilage in saddle nose deformity. Arch Iran Med 2012; 15: 235-238
- 17 Boyce B. Physical characteristics of expanded-polytetrafluoroethylene grafts. In: Stanley JC, ed. Biologic and Synthetic Vascular Prosthesis. New York, NY: Grune & Stratton; 1982: 5553-5561
- 18 Neel III HB. Implants of Gore-Tex. Arch Otolaryngol 1983; 109: 427-433
- 19 McAuley CE, Steed DL, Webster MW. Seven-year follow-up of expanded polytetrafluoroethylene (PTFE) femoropopliteal bypass grafts. Ann Surg 1984; 199: 57-60
- 20 Jin HR, Lee JY, Yeon JY, Rhee CS. A multicenter evaluation of the safety of Gore-Tex as an implant in Asian rhinoplasty. Am J Rhinol 2006; 20: 615-619
- 21 Dong L, Hongyu X, Gao Z. Augmentation rhinoplasty with expanded polytetrafluoroethylene and prevention of complications. Arch Facial Plast Surg 2010; 12: 246-251
- 22 Kawanabe Y, Nagata S. A new method of costal cartilage harvest for total auricular reconstruction: part I. Avoidance and prevention of intraoperative and postoperative complications and problems. Plast Reconstr Surg 2006; 117: 2011-2018