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Facial Plast Surg 2003; 19(1): 041-052
DOI: 10.1055/s-2003-39136
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Auricular Cartilage in Revision Rhinoplasty

Daniel G. Becker1 , Samuel S. Becker2 , Abdel Aziz Saad3
  • 1Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
  • 2Department of Otolaryngology, University of Virginia, Charlottesville, VA
  • 3Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, PA
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Publication History

Publication Date:
09 May 2003 (online)

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ABSTRACT

Revision rhinoplasty is a challenge in reconstruction to the rhinoplasty surgeon, both in the techniques of repair and the choice of implant material for augmentation grafting. Often, patients seeking revision or reconstructive rhinoplasty have previously undergone septoplasty with sacrifice of major amounts of septal cartilage. These situations confront the surgeon with the need for a decision about the material that will be used for structural grafting. The senior author follows the time-tested approach of generations of surgeons who have used exclusively autogenous material for nasal reconstruction because of its superior long-term survival characteristics, its ready availability in the head and neck region, its resistance to infection and resorption, and its bendability and flexibility when implanted in the nose. With this in mind, the subject of this article is the use of auricular cartilage in revision rhinoplasty. Careful strategic planning must be undertaken to get the maximal and ideal benefit from the auricular cartilage. The revision rhinoplasty surgeon must understand the anatomy of the external ear and must be able to manage the precious cartilage supply to get the maximum use of it in reconstructive rhinoplasty.

KEYWORDS

Revision rhinoplasty - auricular cartilage - autogenous implant - alloplasts

REFERENCES

  • 1 Tardy M E. Rhinoplasty: The Art and the Science. Philadelphia, PA: WB Saunders 1997
    Google Scholar
  • 2 Tardy M E, Toriumi D M. Philosophy and principles of rhinoplasty. In: Cummings C, ed. Otolaryngology-Head and Neck Surgery, 2nd ed Mosby-Year Book 278-294
    Google Scholar
  • 3 Kamer F M, Pieper P G. Revision rhinoplasty. In: Bailey B, ed. Head and Neck Surgery-Otolaryngology Philadelphia, PA: Lippincott; 1998
    Google Scholar
  • 4 Johnson Jr C M, Toriumi D M. Open Structure Rhinoplasty. Philadelphia, PA: WB Saunders; 1990
  • 5 Lohuis P J, Watts S J, Vuyk H D. Augmentation of the nasal dorsum using Gore-Tex: intermediate results of a retrospective analysis of experience in 66 patients.  Clin Otolaryngol . 2001;  26(3) 214-217
    CrossrefPubMedGoogle Scholar
  • 6 Godin M S, Waldman S R, Johnson Jr M C. Nasal augmentation using Gortex: a 10-year experience.  Arch Facial Plast Surg . 1999;  1(2) 118-121
    CrossrefPubMedGoogle Scholar
  • 7 Gunter J P, Rohrich R J. Augmentation rhinoplasty: dorsal onlay grafting using shaped autogenous septal cartilage.  Plast Reconstr Surg . 1990;  86(1) 39-45
    CrossrefPubMedGoogle Scholar
  • 8 Metzinger S E, Boyce R G, Rigby P L, Joseph J J, Anderson J R. Ethmoid bone sandwich grafting for caudal septal defects.  Arch Otol Head Neck Surg . 1994;  120(10) 1121-1125
    PubMedGoogle Scholar
  • 9 Tardy M E, Kron T K, Younger R Y, Key M. The cartilaginous pollybeak: etiology, prevention, and treatment.  Facial Plast Surg . 1989;  6(2) 113-120
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Tardy M E, Brown R. Surgical Anatomy of the Nose. New York: Raven Press; 1990
    Google Scholar
  • 11 Larrabee W F, Makielski K H. Surgical Anatomy of the Face. New York: Raven Press; 1983
    Google Scholar
  • 12 Kotler H S, Tardy M E. Reconstruction of the outstanding ear (otoplasty). In: Ballenger JJ, Snow JB, eds. Otorhinolaryngology Head and Neck Surgery, 15th ed Baltimore, MD: Williams & Wilkins 1996: 989-1002
    Google Scholar
  • 13 Toriumi D M, Becker D G. Rhinoplasty Dissection Manual. Philadelphia, PA: Lipppincott, Williams & Wilkins; 1999
    Google Scholar
  • 14 Tardy M E, Denneny J, Fritsch M H. The versatile cartilage autograft in reconstruction of the nose and face.  Laryngoscope . 1985;  95 523-532
    PubMedGoogle Scholar
  • 15 Tardy M E, Schwartz M, Parras G. Saddle nose deformity: autogenous graft repair.  Facial Plast Surg . 1989;  6(2) 121-134
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Wang T D. Aesthetic structural nasal augmentation.  Oper Tech Otolaryngol Head Neck Surg . 1990;  10 50-54
    PubMedGoogle Scholar
  • 17 Daniel R K. Rhinoplasty and rib grafts: evolving a flexible operative technique.  Plast Reconstr Surg . 1992;  94(5) 597-611
    PubMedGoogle Scholar
  • 18 Gunter J P, Clark C P, Friedman R M. Internal stabilization of autogenous rib cartilage grafts in rhinoplasty: a barrier to cartilage warping.  Plast Reconstr Surg . 1997;  100(1) 161-169
    CrossrefPubMedGoogle Scholar
  • 19 Murakami C S, Cook T A, Guida R A. Nasal reconstruction with articulated irradiated rib cartilage.  Arch Otolaryngol Head Neck Surg . 1991;  117 327-330
    CrossrefPubMedGoogle Scholar
  • 20 Toriumi D M, Josen J, Weinberger M S, Tardy M E. Use of alar batten grafts for correction of nasal valve collapse.  Arch Otol Head Neck Surg . 1997;  123 802-808
    CrossrefPubMedGoogle Scholar
  • 21 Tardy M E, Toriumi D M. Alar retraction: composite graft correction.  Facial Plast Surg . 1989;  6(2) 101-107
    Article in Thieme ConnectPubMedGoogle Scholar