Use of Roof-Shaped Costochondral Cartilage for Correction of Saddle Nose Deformity.

Abstract:

BACKGROUND:Cartilage grafts are routinely used in secondary and posttraumatic rhinoplasty. However, in most cases, there are weak areas in the nasal bones and upper lateral cartilages. The purpose of this study was to seek a solution for the keystone area and dorsum of the nose in revision and posttraumatic rhinoplasty cases, and reconstruction of saddle nose deformity including upper lateral cartilage with a roof-shaped graft. METHODS:A retrospective review of reconstructive rhinoplasties performed for saddle nose deformities was conducted. A part of the costochondral graft was carved and thinned (roof graft) for reconstruction of the keystone area and upper lateral cartilages, and another portion was used for making a neoseptal (reconstructed septum) graft and strut graft. The roof graft was capped onto the neoseptal graft with sutures, and this cartilage framework was adapted with fitting the cranial edge of the neoseptal cartilage between the nasal bones. Finally, the strut graft was fixed to the cartilage framework. RESULTS:A significant improvement in nasal shape and overall appearance was achieved in all cases, and 71.42 percent of patients recovered from nasal obstruction. No gross absorption, graft exposure, or recurrence of deformities was observed. CONCLUSIONS:Surgical correction of a saddle-shaped nose should be an acceptable and uncomplicated technique, and the cosmetic result should be totally acceptable. There are many management options for a saddle-shaped nose. Use of roof grafts (shrunk gull-wing grafts) with neoseptal and strut grafts enables simulation of the internal nasal valve and results in a natural nasal position. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.

journal_name

Plast Reconstr Surg

authors

Irmak F,Yazar SK,Sirvan SS,Yazar M,Karsidag S

doi

10.1097/PRS.0000000000004459

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

45-52

issue

1

eissn

0032-1052

issn

1529-4242

pii

00006534-201807000-00007

journal_volume

142

pub_type

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