Advertisement

Aesthetic Plastic Surgery

, Volume 27, Issue 3, pp 213–220 | Cite as

Irradiated Homologous Costal Cartilage: Versatile Grafting Material for Rhinoplasty

  • Ferit DemirkanEmail author
  • Emrah Arslan
  • Sakir Unal
  • Alper Aksoy
Article

Abstract

For most surgeons, nasal septal cartilage is the first choice in septoplasty. However, when this source is depleted, an alloplastic implant material might be preferable over other autogenous donor sites in order to avoid additional scars, morbidity, and lengthened operating time. In the alloplastic spectrum, irradiated costal cartilage (ICC) has certain advantages. Herein, we present our results with ICC in a wide range of septorhinoplasties to show its versatility and reliability. Sixty-five patients were included in the study. There were 42 male and 23 female patients. According to the indications, there were four groups of patients: (I) secondary septorhinoplasty (n = 24), (II) traumatic deformity (n = 21), (III) primary septorhinoplasty (n = 13), (IV) deformity due to previous septal surgery (n = 7). The mean follow-up period was 33 months. No significant resorption was detected in any of the patients. Minor complications developed in four cases (6%), including deformity in the dorsal graft, excessive graft length, and erythematous nasal tips. Aesthetic and functional results were satisfactory in the remaining cases. The low incidence of major complications and the versatility of ICC make it a safe and reliable source of cartilage graft for both primary and secondary septorhinoplasties when autogenous septal cartilage is either insufficient or unsuitable.

Keywords

Costal cartilage Septorhinoplasty Graft 

References

  1. 1.
    Adams, WP, Rodrich, RJ, Hollier, LH, Minoli, J, Thornton, LK, Gyimesi, I 1997Anatomic basis and clinical implications for nasal tip support in open versus closed rhinoplasty.Plast Reconstr Surg103255261Google Scholar
  2. 2.
    Adams, WP, Rodrich, RJ, Gunter, JP, Clark, CP, Robinson, JB 1999The rate of warping in irradiated and nonirradiated homograft rib cartilage: A controlled comparison and clinical implications.Plast Reconstr Surg103265270Google Scholar
  3. 3.
    Alechniewicz, A 1964Research on grafted conserved homogenous cartilage.Acta Chir Plast6229233Google Scholar
  4. 4.
    Andrade, M, Fernandes, VS, Boleo-Tome, JP 1999Saddle nose: Our approach to the problem.Aesthetic Plast Surg23403406CrossRefPubMedGoogle Scholar
  5. 5.
    Babin, RW, Ryu, JH, Gantz, BJ, Maynard, JA 1982Survival of implanted irradiated cartilage.Otolaryngol Head Neck Surg907580PubMedGoogle Scholar
  6. 6.
    Bateman, N, Jones, NS 2000Retrospective review of augmentation rhinoplasties using autologous cartilage grafts.J Laryngol Otol114514518Google Scholar
  7. 7.
    Cardenas-Camarena, L, Guerrero, MT 1999Use of cartilaginous autografts in nasal surgery: 8 years of experience.Plast Reconstr Surg10310031014Google Scholar
  8. 8.
    Chaffoo, RAK, Goode, RL 1989Irradiated homologous cartilage in augmentation rhinoplasty.Stucker, FJ eds. Plastic and reconstructive surgery of the head and neck, proceedings of the Fifth International Symposium.BC DeckerPhiladelphia297305Google Scholar
  9. 9.
    Collawn, SS, Fix, J, Moore, JR, Vasconez, LO 1997Nasal cartilage grafts: More than a decade of experience.Plast Reconstr Surg10015471552Google Scholar
  10. 10.
    Conrad, K, Gillman, G 1998A 6-year experience with the use of expanded polytetrafluoroethylene in rhinoplasty.Plast Reconstr Surg10116751683Google Scholar
  11. 11.
    Crumley, RL 1993Editorial footnote.Arch Otolaryngol Head Neck Surg1193031Google Scholar
  12. 12.
    Deva, AK, Mertern, S, Chang, L 1998Silicone in nasal augmentation rhinoplasty: A decade of clinical experience.Plast Reconstr Surg10212301237Google Scholar
  13. 13.
    Donald, PJ, Col, A 1982Cartilage implantation in head and neck surgery: Report of a national survey.Otolaryngol Head Neck Surg908590PubMedGoogle Scholar
  14. 14.
    Donald, PJ 1986Cartilage grafting in facial reconstruction with special consideration of irradiated grafts.Laryngoscope96786807Google Scholar
  15. 15.
    Erol, OO 2000The Turkish delight: A pliable graft for rhinoplasty.Plast Reconstr Surg10522292241Google Scholar
  16. 16.
    Gibson, T 1957The distortion of autogenous cartilage grafts: Its causes and prevention.Br J Plast Surg10257262Google Scholar
  17. 17.
    Gryskiewicz, JM, Rohrich, RJ, Reagan, BJ, Schwartz, BM 2001The use of alloderm for the correction of nasal contour deformities.Plast Reconstr Surg107571Google Scholar
  18. 18.
    Hiraga, Y 1980Complications of augmentation rhinoplasty in the Japanese.Ann Plast Surg24495499Google Scholar
  19. 19.
    Juraha, LZ 1992Experience with alternative material for nasal augmentation.Aesthetic Plast Surg16113140Google Scholar
  20. 20.
    Kridel, RW, Konior, RJ 1993Irradiated cartilage grafts in the nose. A preliminary report.Arch Otolaryngol Head Neck Surg1192430Google Scholar
  21. 21.
    Lefkovits, G 1990Irradiated homologous costal cartilage for augmentation rhinoplasty.Ann Plast Surg92317327Google Scholar
  22. 22.
    McKinney, P, Loomis, MG, Wiedrich, TA 1993Reconstruction of the nasal cap with a thin septal graft.Plast Reconstr Surg92346351Google Scholar
  23. 23.
    Murakami, CS, Cook, TA, Guida, RA 1991Nasal reconstruction with articulated irradiated rib cartilage.Arch Otolaryngol Head Neck Surg117327330Google Scholar
  24. 24.
    Ortiz-Monasterio, F, Olmedo, A, Oscoy, LO 1981The use of cartilage grafts in primary aesthetic rhinoplasty.Plast Reconstr Surg67597605Google Scholar
  25. 25.
    Ramirez, OM, Pozner, JN 1996The severely twisted nose. Treatment by seperation of its components and internal splinting.Clin Plast Surg23327340PubMedGoogle Scholar
  26. 26.
    Rohrich, RR, Hollier, LH 1996Use of spreader grafts in the external approach to rhinoplasty.Clin Plast Surg23255262PubMedGoogle Scholar
  27. 27.
    Romo 3rd, T, Sclafani, AP, Sabini, P 1998Use of porous high-density polyethylene in revision rhinoplasty and in the platyrrhine nose.Aesthetic Plast Surg22211221CrossRefPubMedGoogle Scholar
  28. 28.
    Schuller, DE, Bardach, J, Krause, CJ 1977Irradiated homologous costal cartilage for facial contour restoration.Arch Otolaryngol1031215Google Scholar
  29. 29.
    Sevin, K, Askar, I, Saray, A, Yormuk, E 2000Exposure of high-density porous polyethylene (Medpor) used for contour restoration and treatment.Br J Oral Maxillofac Surg384449PubMedGoogle Scholar
  30. 30.
    Smith, JW, Kawamoto, HK 1973Saddle nose deformity. Symposium on aesthetic surgery of the nose, ears and chin.CV MosbySaint Louis9195Google Scholar
  31. 31.
    Stoksted, P, Ladefoged, C 1986Crushed cartilage in nasal reconstruction.J Laryngol Otol100897906Google Scholar
  32. 32.
    Tardy, ME, Denneny, J, Fritsch, MH 1985The versatile cartilage autograft in reconstruction of the nose and face.Laryngoscope95523533Google Scholar
  33. 33.
    Toriumi, DM 2000Autogenous grafts are worth the extra time.Arch Otolaryngol Head Neck Surg126562564Google Scholar
  34. 34.
    Tzadik, A, Gilbert, SE, Sade, J 1988Complications of submucous resections of the nasal septum.Arch Otorhinolaryngol2457476PubMedGoogle Scholar
  35. 35.
    Welling, RO, Maves, MD, Schuller, DE, Bardach, J 1988Irradiated homologous cartilage grafts, long-term results.Arch Otolaryngol Head Neck Surg114291295Google Scholar
  36. 36.
    Dingman, DB, Grabb, WC 1972Costal Cartilage homografts preserved by radiation..Plast Reconstr Surg50516Google Scholar
  37. 37.
    Dingman, DB, Grabb, WC 1961Costal Cartilage homografts preserved by radiation..Plast Reconstr Surg28562570Google Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Ferit Demirkan
    • 1
    Email author
  • Emrah Arslan
    • 1
  • Sakir Unal
    • 1
  • Alper Aksoy
    • 1
  1. 1.University of Mersin, Department of Plastic and Reconstructive SurgeryMersinTurkey

Personalised recommendations