Autologous Rib Grafts in the Management of the Crooked Nose

Abstract

Rhinoplasty is arguably one of the most challenging procedures a facial plastic surgeon performs. Numerous techniques have been developed since the inception of rhinoplasty to aid in correction of aesthetic and functional issues. Congenital, iatrogenic, and traumatic etiologies can all lead to a crooked nose. Autologous rib or costal cartilage grafting is a powerful tool that can aid the surgeon in successful correction of the crooked nose.

Keywords

rhinoplasty - costal cartilage - crooked nose

• References

• 1 Kienstra M. Secondary rhinoplasty: revising the crooked nose. Facial Plast Surg 2011; 27 (5) 491-496
• 2 Antunes MB, Goldstein SA. Surgical approach to nasal valves and the midvault in patients with a crooked nose. Facial Plast Surg 2011; 27 (5) 422-436
• 3 McDowell F. Reconstruction of saddlenose by cartilage overlay. Dr. von Mangoldt, Dresden, Germany. (Deutsche Gesell. f. chir., 29: 460, 1900). Plast Reconstr Surg 1970; 46 (5) 498-501
• 4 Cakmak O, Ergin T. The versatile autogenous costal cartilage graft in septorhinoplasty. Arch Facial Plast Surg 2002; 4 (3) 172-176
• 5 Lee M, Callahan S, Cochran CS. Auricular cartilage: harvest technique and versatility in rhinoplasty. Am J Otolaryngol 2011; 32 (6) 547-552
• 6 Dingman RO, Grabb WC. Costal cartilage homografts preserved by irradiation. Plast Reconstr Surg Transplant Bull 1961; 28: 562-567
• 7 Welling DB, Maves MD, Schuller DE, Bardach J. Irradiated homologous cartilage grafts. Long-term results. Arch Otolaryngol Head Neck Surg 1988; 114 (3) 291-295
• 8 Lovice DB, Mingrone MD, Toriumi DM. Grafts amd implants in rhinoplasty and nasal reconstruction. Otolaryngol Clin North Am 1999; 32 (1) 113-141
• 9 Winkler AA, Soler ZM, Leong PL, Murphy A, Wang TD, Cook TA. Complications associated with alloplastic implants in rhinoplasty. Arch Facial Plast Surg 2012; 14 (6) 437-441
• 10 Ching WC, Hsiao YC. Transumbilical endoscopic costal cartilage harvesting: a new technique. Ann Plast Surg 2014; 72 (4) 423-427
• 11 Kobayashi S, Yoza S, Takada H, Nagase T, Ohmori K. Endoscope-assisted rib cartilage harvesting. Ann Plast Surg 1995; 35 (6) 571-575
• 12 Miranda N, Larocca CG, Aponte C. Rhinoplasty using autologous costal cartilage. Facial Plast Surg 2013; 29 (3) 184-192
• 13 Uppal RS, Sabbagh W, Chana J, Gault DT. Donor-site morbidity after autologous costal cartilage harvest in ear reconstruction and approaches to reducing donor-site contour deformity. Plast Reconstr Surg 2008; 121 (6) 1949-1955
• 14 Ohara K, Nakamura K, Ohta E. Chest wall deformities and thoracic scoliosis after costal cartilage graft harvesting. Plast Reconstr Surg 1997; 99 (4) 1030-1036
• 15 Thomson HG, Kim TY, Ein SH. Residual problems in chest donor sites after microtia reconstruction: a long-term study. Plast Reconstr Surg 1995; 95 (6) 961-968
• 16 Wallace CG, Mao HY, Wang CJ, Chen YA, Chen PK, Chen ZC. Three-dimensional computed tomography reveals different donor-site deformities in adult and growing microtia patients despite total subperichondrial costal cartilage harvest and donor-site reconstruction. Plast Reconstr Surg 2014; 133 (3) 640-651
• 17 Goodman TR, Traill ZC, Phillips AJ, Berger J, Gleeson FV. Ultrasound detection of pneumothorax. Clin Radiol 1999; 54 (11) 736-739
• 18 McCarn KE, Weber SM. Ultrasonography for rapid detection of pneumothorax after costal cartilage harvest. Arch Facial Plast Surg 2011; 13 (1) 57-59
• 19 Davis WB, Gibson T. Absorption of autogenous cartilage grafts in man. Br J Plast Surg 1956; 9 (3) 177-185
• 20 Kim DW, Shah AR, Toriumi DM. Concentric and eccentric carved costal cartilage: a comparison of warping. Arch Facial Plast Surg 2006; 8 (1) 42-46
• 21 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 (1) 161-169
• 22 Balaji SM. Costal cartilage nasal augmentation rhinoplasty: study on warping. Ann Maxillofac Surg 2013; 3 (1) 20-24
• 23 Bloom JD, Immerman SB, Constantinides M. Osteotomies in the crooked nose. Facial Plast Surg 2011; 27 (5) 456-466
• 24 Webster RC, Davidson TM, Smith RC. Curved lateral osteotomy for airway protection in rhinoplasty. Arch Otolaryngol 1977; 103 (8) 454-458
• 25 Dobratz EJ, Hilger PA. Osteotomies. Clin Plast Surg 2010; 37 (2) 301-311
• 26 Parkes ML, Kamer F, Morgan WR. Double lateral osteotomy in rhinoplasty. Arch Otolaryngol 1977; 103 (6) 344-348
• 27 Sheen JH. Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty. Plast Reconstr Surg 1984; 73 (2) 230-239
• 28 Cerkes N. The crooked nose: principles of treatment. Aesthet Surg J 2011; 31 (2) 241-257
• 29 Sadooghi M, Ghazizadeh M. Extended osteocartilaginous spreader graft for reconstruction of deviated nose. Otolaryngol Head Neck Surg 2012; 146 (5) 712-715
• 30 Arslan E. No osteotomy rhinoplasty: indications and surgical details. Aesthetic Plast Surg 2014; 38 (1) 57-62
• 31 Gunter JP, Friedman RM. Lateral crural strut graft: technique and clinical applications in rhinoplasty. Plast Reconstr Surg 1997; 99 (4) 943-952 , discussion 953–955
• 32 Gunter JP, Rohrich RJ. Management of the deviated nose. The importance of septal reconstruction. Clin Plast Surg 1988; 15 (1) 43-55
• 33 Pastorek NJ, Becker DG. Treating the caudal septal deflection. Arch Facial Plast Surg 2000; 2 (3) 217-220
• 34 Pontius AT, Leach Jr JL. New techniques for management of the crooked nose. Arch Facial Plast Surg 2004; 6 (4) 263-266
• 35 Rees TD. Surgical correction of the severely deviated nose by extramucosal excision of the osseocartilaginous septum and replacement as a free graft. Plast Reconstr Surg 1986; 78 (3) 320-330