Abstract
Background
Conchal cartilage is generally favored in rhinoplasty with a satisfied aesthetic outcome. However, patients may suffer from postoperative donor auricle deformities.
Objectives
This study introduced a novel conchal cartilage harvesting technique which can minimize the deformity of auricle and harvest the sufficient amounts of grafts.
Methods
This study proposed preservation of the concha cymba and cavum support structures to minimize the deformity of auricle and harvest of cartilage hidden in the craniofacial region to obtain the sufficient amounts. The medical records of 60 patients who underwent the novel conchal cartilage harvesting were reviewed retrospectively. Postoperative aesthetic outcomes were assessed by comparing pre- and postoperative photographs according to the deformation extent of auricular subunits (cymba concha, cavum concha, antihelix, helix crus and intertragal notch) on a four-point Likert scale. Additionally, function and complications were analyzed.
Results
56 patients performed unilateral conchal cartilage harvesting (8 with right-side and 48 with left-side) and 4 performed bilateral harvesting. The average aesthetic score, rated on a four-point Likert scale (1 = significant deformation, 2 = moderated deformation, 3 = slight deformation, 4 = complete no deformation), were 3.83 ± 0.03 points, respectively. The functional scores, rated on a four-point Likert scale (1 = significant damage, 2 = moderated damage, 3 = slight damage, 4 = complete no damage), was 3.94±0.03. Complications included hematoma, delayed wound healing and hypopigmentated scar in six ears (9.4%).
Conclusions
This novel technique can minimize the deformity of auricle, as shown by the outcome scores, and allows for sufficient amount of grafting material acquired.
Level of Evidence IV
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References
Sajjadian A, Rubinstein R, Naghshineh N (2010) Current status of grafts and implants in rhinoplasty: Part I. autologous grafts. Plast Reconstr Surg 125(2):40e–49e. https://doi.org/10.1097/PRS.0b013e3181c82f12
Gunter JP, Landecker A, Cochran CS (2006) Frequently used grafts in rhinoplasty: nomenclature and analysis. Plast Reconstr Surg 118(1):14e–29e. https://doi.org/10.1097/01.prs.0000221222.15451.fc
Moshaver A, Gantous A (2007) The use of autogenous costal cartilage graft in septorhinoplasty. Otolaryngol Head Neck Surg 137(6):862–867. https://doi.org/10.1016/j.otohns.2007.06.740
Ohara K, Nakamura K, Ohta E (1997) Chest wall deformities and thoracic scoliosis after costal cartilage graft harvesting. Plast Reconstr Surg 99(4):1030–1036. https://doi.org/10.1097/00006534-199704000-00017
Otley CC, Sherris DA (1998) Spectrum of cartilage grafting in cutaneous reconstructive surgery. J Am Acad Dermatol 39(6):982–992. https://doi.org/10.1016/S0190-9622(98)70274-9
Ortiz-Monasterio F, Olmedo A, Oscoy LO (1981) The use of cartilage grafts in primary aesthetic rhinoplasty. Plast Reconstr Surg 67(5):597–605. https://doi.org/10.1097/00006534-198105000-00003
Dai M, Sui B, Hua Y et al (2020) A well defect-suitable and high-strength biomimetic squid type II gelatin hydrogel promoted in situ costal cartilage regeneration via dynamic immunomodulation and direct induction manners. Biomaterials 240:119841. https://doi.org/10.1016/j.biomaterials.2020.119841
Horn CE, Honrado CP, Khosh MM (2004) Closure of conchal cartilage harvest sites via absorbable quilting suture. Arch Facial Plast Surg 6(3):202–203. https://doi.org/10.1001/archfaci.6.3.202
Seven E, Tellioglu AT, Inozu E et al (2017) Reconstruction of orbital floor with auricular concha. J Craniofac Surg 28(7):e713–e717. https://doi.org/10.1097/SCS.0000000000003921
Liu X, Zhou T, Zhao T, Xu Z (2021) Reconstruction of an iatrogenic anterior conchal defect with a revolving-door flap. BMC Surg 21(1):25. https://doi.org/10.1186/s12893-020-01020-2
Lan MY, Park JP, Jang YJ (2017) Donor site morbidities resulting from conchal cartilage harvesting in rhinoplasty. J Laryngol Otol 131(6):529–533. https://doi.org/10.1017/S0022215117000639
Zinser MJ, Siessegger M, Thamm O et al (2013) Comparison of different autografts for aural cartilage in aesthetic rhinoplasty: Is the tragal cartilage graft a viable alternative? Br J Oral Maxillofac Surg 51(8):863–867. https://doi.org/10.1016/j.bjoms.2013.04.001
Mischkowski RA, Domingos-Hadamitzky C, Siessegger M, Zinser MJ, Zöller JE (2008) Donor-site morbidity of ear cartilage autografts. Plast Reconstr Surg 121(1):79–87. https://doi.org/10.1097/01.prs.0000293879.46560.4c
Adams WM (1955) Construction of upper half of auricle utilizing composite concha cartilage graft with perichondrium attached on both sides. Plast Reconstr Surg 16(2):88–96. https://doi.org/10.1097/00006534-195508000-00002
Gorney M, Murphy S, Falces E (1971) Spliced autogenous conchal cartilage in secondary ear reconstruction. Plast Reconstr Surg 47(5):432–437. https://doi.org/10.1097/00006534-197105000-00004
Sullivan PK, Tattini CD (2003) Grafting the nasal dorsum with tandem ear cartilage; Ronald P. Gruber, M.D., Jeff Pardun, M.D., and Simeon Wall, M.D. Plast Reconstr Surg 112(4):1123–1124. https://doi.org/10.1097/01.PRS.0000076499.10584.6C
Han K, Kim J, Son D, Park B (2008) How to harvest the maximal amount of conchal cartilage grafts. J Plast Reconstr Aesthet Surg 61(12):1465–1471. https://doi.org/10.1016/j.bjps.2007.09.038
Brockhoff HC, Morris CD, Throckmorton GS, Finn R (2014) Anatomic analysis of the conchal bowl cartilage. J Oral Maxillofac Surg 72(11):2248–2255. https://doi.org/10.1016/j.joms.2014.04.024
Boccieri A, Marano A (2007) The conchal cartilage graft in nasal reconstruction. J Plast Reconstr Aesthet Surg 60(2):188–194. https://doi.org/10.1016/j.bjps.2006.02.005
Grobbelaar AO, Matti BA, Nicolle FV (1997) Donor site morbidity post-conchal cartilage grafting. Aesthet Plast Surg 21(2):90–92. https://doi.org/10.1007/s002669900090
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This research was funded by Key R&D project of Sichuan Provincial Department of Science and Technology (2023YFS0124), the Industry-University-Research innovation fund of the Science and Technology Development Center, Ministry of Education of China (2021JH011) and the Youth Talent Fund of Sichuan Provincial People’s Hospital (2022QN58).
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Li, Q., Chen, Z., Jiang, Z. et al. A Novel Conchal Cartilage Harvesting Technique. Aesth Plast Surg (2024). https://doi.org/10.1007/s00266-024-03958-7
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DOI: https://doi.org/10.1007/s00266-024-03958-7