Abstract
Rhinoplasty has grown and developed over so many years but the choice of the graft material in revision rhinoplasty and rhinoplasty for post-traumatic cases still remains debatable. In such patients, non-availability of adequate autogenous graft, multiple septal fractures and skin fibrosis are a challenge to the rhinologist. To deal with this problem authors have used diced cartilage pieces as a grafting material. Secondary rhinoplasty for correction of the nasal dorsum was done in 32 patients and evaluated. The study, highlights the distinct advantages of using diced cartilage wrapped in fascia for dorsal augmentation. Full length grafts were used in all patients and this was supported on a L-shaped cartilage fixed between the two upper lateral cartilage. Fascial tube was prepared from fascia lata and conchal, rib or septal cartilage was the source of diced cartilage (0.5–1 mm sized pieces). The L-shaped structural support was prepared from the remnant of septal cartilage if any or from the conchal or rib cartilage. Patients were followed for a period of 6 months–3 years. In 30 patients post-op course was uneventful with good reconstruction results. Step-deformity was encountered in one patient and in another patient the tube opened with extrusion of diced cartilage pieces. Both these patients were effectively managed. In conclusion, diced cartilage wrapped in fascial tube has distinct advantages like it is simpler procedure and graft material is adequate and autogenous. Grafts can be prepared as per the desired length, shape and size to fit the specific defect. These being highly malleable can be used without any tension on the already thickened and fibrosed skin and soft tissue. Complications like step deformity and extrusion rarely occur and can be easily managed. Over correction and graft visibility were not met with.
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References
Breadon GE, Kern EB, Neel B III (1979) Autografts of uncrushed and crushed bone and cartilage: experimental observations and clinical observations. Arch Otolaryngol 105:75–80
Daniel RK (2008) Diced cartilage grafts in rhinoplasty: current techniques and applications. Plast Reconstr Surg 122(6):1883–1891
Daniel RK (2006) The role of diced cartilage grafts in rhinoplasty. Aesthet Surg J 26:209–213
Harma ST (1993) Diced cartilage grafts in rhinoplasty. Plast Reconstr Surg 116(2):352–356
Peer LA (1943) Diced cartilage grafts. Arch Otolaryngol 38:156–165
Erol OO (2000) The turkish delight: a pliable method for rhinoplasty. Plast Reconstr Surg 105:2229–2241
Peer LA (1945) The neglected septal cartilage (with experimental observations on the growth of human cartilage grafts). Arch Otolaryngol 42:384–396
Parker Porter J (2000) Grafts in rhinoplasty: alloplastic versus autogenous. Arch Otolaryngol Head Neck Surg 126:558–561
Cakmak O, Ergin NT (2002) The versatile autogenous coastal cartilage graft in septorhinoplasty. Arch Fac Plast Surg 4:172–176
Baker TM, Cortiss EH (1994) Temporalis grafts in open secondary rhinoplasty. Plast Reconstr Surg 93:802–810
Reich J (1983) The application of dermis grafts in deformities of the nose. Plast Reconstr Surg 71:772–782
Stoksted P, Ladefoged C (1986) Crushed cartilage in nasal reconstruction. J Laryngol Otol 100:897–906
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Baser, B., Kothari, S. & Thakur, M. Diced Cartilage: An Effective Graft for Post-Traumatic and Revision Rhinoplasty. Indian J Otolaryngol Head Neck Surg 65 (Suppl 2), 356–359 (2013). https://doi.org/10.1007/s12070-012-0525-6
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DOI: https://doi.org/10.1007/s12070-012-0525-6