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Grafting in Nasal Reconstruction

  • Uzdan UzEmail author
  • Görkem Eskiizmir
  • David Sherris
Chapter

Abstract

Nasal reconstruction after tissue loss requires understanding of multiple complex surgical techniques and principles aimed at restoring anatomic integrity, function, and aesthetics of the nose. The reconstruction form and function of the nose are generally challenging when compared to other regions of the face. The outer skin and soft tissue envelope the cartilaginous and bony structure, and the mucosal lining should be considered in the reconstruction of each defect. This chapter is mainly focused on graft materials that are commonly used for nasal reconstruction. A graft is any type of tissue that is harvested from a donor site and transferred to a recipient site without carrying its own blood supply. After transplantation, a newly formed blood supply (angiogenesis) grows toward the graft. Grafts are divided into three categories according to their sources: (1) autografts, (2) homografts, and (3) xenografts. Autografts, or autogenous grafts, designate tissues that are harvested from a site and transplanted on other site of the same patient. Skin, cartilage, fascia, fat, and bone grafts can be used for the reconstruction of various nasal defects or deformities. Indeed, autogenous grafts are the gold standard graft materials for nasal reconstruction due to low rates of rejection, infection, and extrusion. If the donor and recipient are the same species but a different host, the graft is called as homograft. Homograft is divided into two groups: (1) isograft (donor and recipient have the same genetic material as in monozygotic twins) and (2) allograft (the tissue is transferred between genetically nonidentical members of same species). Xenografts are tissue that is harvested from one species and transplanted into another species. Xenografts are generally indicated for closure of post-Mohs surgery in massive wounds, and act as biological dressings to allow for wound granulation and epithelialization.

Keywords

Nasal reconstruction Graft Autografts Homografts Xenografts 

References

  1. 1.
    Sherris AD, Larrabee WF. Principles of Facial Reconstruction: A Subunit Approach to Cutaneous Repair. New York: Thieme; 2010.Google Scholar
  2. 2.
    Otley CC, Sherris DA. Spectrum of cartilage grafting in cutaneous reconstructive surgery. J Am Acad Dermatol. 1998;39(6):982–92.PubMedGoogle Scholar
  3. 3.
    Toriumi DM. Autogenous grafts are worth the extra time. Arch Otolaryngol Head Neck Surg. 2000;126(4):562–4.PubMedGoogle Scholar
  4. 4.
    Gottlieb LJ, Krieger LM. From the reconstructive ladder to the reconstructive elevator. Plast Reconstr Surg. 1994;93(7):1503–4.PubMedGoogle Scholar
  5. 5.
    Andreassi A, et al. Classification and pathophysiology of skin grafts. Clin Dermatol. 2005;23(4):332–7.PubMedGoogle Scholar
  6. 6.
    Ibrahim AM, et al. Common patterns of reconstruction for Mohs defects in the head and neck. J Craniofac Surg. 2014;25(1):87–92.PubMedGoogle Scholar
  7. 7.
    Greenwood J, et al. Real-time demonstration of split skin graft inosculation and integra dermal matrix neovascularization using confocal laser scanning microscopy. Eplasty. 2009;9:e33.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Rohrich RJ, et al. Nasal reconstruction--beyond aesthetic subunits: a 15-year review of 1334 cases. Plast Reconstr Surg. 2004;114(6):1405–16; discussion 1417-9PubMedGoogle Scholar
  9. 9.
    Lutz ME. Effective use of the glabella skin as a donor site for nasal tip grafts. Dermatol Surg. 2002;28(1):101–2.PubMedGoogle Scholar
  10. 10.
    Konofaos P, et al. Nasal Reconstruction: A Simplified Approach Based on 419 Operated Cases. Aesthet Plast Surg. 2015;39(1):91–9.Google Scholar
  11. 11.
    Woodard CR, Park SS. Reconstruction of nasal defects 1.5 cm or smaller. Arch Facial Plast Surg. 2011;13(2):97–102.PubMedGoogle Scholar
  12. 12.
    Park SS. Nasal reconstruction in the 21st century--a contemporary review. Clin Exp Otorhinolaryngol. 2008;1(1):1–9.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Stucker FJ Jr, Shaw GY. The perichondrial cutaneous graft. A 12-year clinical experience. Arch Otolaryngol Head Neck Surg. 1992;118(3):287–92.PubMedGoogle Scholar
  14. 14.
    Love CW, et al. Perichondrial cutaneous grafts for reconstruction of skin cancer excision defects. Dermatol Surg. 1995;21(3):219–22.PubMedGoogle Scholar
  15. 15.
    Hubbard TJ. Leave the fat, skip the bolster: thinking outside the box in lower third nasal reconstruction. Plast Reconstr Surg. 2004;114(6):1427–35.PubMedGoogle Scholar
  16. 16.
    Haack S, Gubisch W. Reconstruction of the septum with an autogenous double-layered conchal L-strut. Aesthet Plast Surg. 2014;38(5):912–22.Google Scholar
  17. 17.
    Jang YJ, et al. Combined use of crushed cartilage and processed fascia lata for dorsal augmentation in rhinoplasty for Asians. Laryngoscope. 2009;119(6):1088–92.PubMedGoogle Scholar
  18. 18.
    Gassner HG. Structural grafts and suture techniques in functional and aesthetic rhinoplasty. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2010;9:Doc01.PubMedGoogle Scholar
  19. 19.
    Allcroft RA, Friedman CD, Quatela VC. Cartilage grafts for head and neck augmentation and reconstruction. Autografts and homografts. Otolaryngol Clin N Am. 1994;27(1):69–80.Google Scholar
  20. 20.
    Sherris DA, Oriel BS. Human acellular dermal matrix grafts for rhinoplasty. Aesthet Surg J. 2011;31(7 Suppl):95S–100S.PubMedGoogle Scholar
  21. 21.
    Daniel RK. Diced cartilage grafts in rhinoplasty surgery: current techniques and applications. Plast Reconstr Surg. 2008;122(6):1883–91.PubMedGoogle Scholar
  22. 22.
    Sherris DA, Kern EB. The versatile autogenous rib graft in septorhinoplasty. Am J Rhinol. 1998;12(3):221–7.PubMedGoogle Scholar
  23. 23.
    Lee M, Inman J, Ducic Y. Central segment harvest of costal cartilage in rhinoplasty. Laryngoscope. 2011;121(10):2155–8.PubMedGoogle Scholar
  24. 24.
    Foulad A, et al. Stabilization of costal cartilage graft warping using infrared laser irradiation in a porcine model. Arch Facial Plast Surg. 2010;12(6):405–11.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Park SW, et al. Various applications of deep temporal fascia in rhinoplasty. Yonsei Med J. 2015;56(1):167–74.PubMedGoogle Scholar
  26. 26.
    Calvert J, Kwon E. Techniques for diced cartilage with deep temporalis fascia graft. Facial Plast Surg Clin North Am. 2015;23(1):73–80.PubMedGoogle Scholar
  27. 27.
    Brenner KA, et al. Survival of diced cartilage grafts: an experimental study. Plast Reconstr Surg. 2006;117(1):105–15.PubMedGoogle Scholar
  28. 28.
    Virkkula P, Makitie AA, Vento SI. Surgical outcome and complications of nasal septal perforation repair with temporal fascia and periosteal grafts. Clin Med Insights Ear Nose Throat. 2015;8:7–11.PubMedPubMedCentralGoogle Scholar
  29. 29.
    Baptista C, et al. Correction of sequelae of rhinoplasty by lipofilling. J Plast Reconstr Aesthet Surg. 2013;66(6):805–11.PubMedGoogle Scholar
  30. 30.
    Xing L, et al. Ophthalmic artery occlusion secondary to fat emboli after cosmetic nasal injection of autologous fat. Retina. 2012;32(10):2175–6.PubMedGoogle Scholar
  31. 31.
    Sathe N, et al. Fixation of nasal bone grafts with interosseous wire: our technique. J Laryngol Otol. 2011;125(2):199–203.PubMedGoogle Scholar
  32. 32.
    Sadooghi M, Kouhi A. Mastoid bone as a new graft material in rhinoplasty. Am J Rhinol Allergy. 2009;23(6):e42–6.PubMedGoogle Scholar
  33. 33.
    Gurlek A, et al. The use of lower turbinate bone grafts in the treatment of saddle nose deformities. Aesthet Plast Surg. 2002;26(6):407–12.Google Scholar
  34. 34.
    Christophel JJ, Hilger PA. Osseocartilaginous rib graft rhinoplasty: a stable, predictable technique for major dorsal reconstruction. Arch Facial Plast Surg. 2011;13(2):78–83.PubMedGoogle Scholar
  35. 35.
    Zins JE, Whitaker LA. Membranous versus endochondral bone: implications for craniofacial reconstruction. Plast Reconstr Surg. 1983;72(6):778–85.PubMedGoogle Scholar
  36. 36.
    Thomassin JM, Paris J, Richard-Vitton T. Management and aesthetic results of support grafts in saddle nose surgery. Aesthet Plast Surg. 2001;25(5):332–7.Google Scholar
  37. 37.
    Movahed R, et al. Application of cranial bone grafts for reconstruction of maxillofacial deformities. Proc. Bayl Univ Med Cent. 2013;26(3):252–5.Google Scholar
  38. 38.
    Strong EB, Moulthrop T. Calvarial bone graft harvest: a new technique. Otolaryngol Head Neck Surg. 2000;123(5):547–52.PubMedGoogle Scholar
  39. 39.
    Qi L, et al. Results of 10-year follow-up of the iliac donor site of graft patients. J Int Med Res. 2014;42(6):1348–52.PubMedGoogle Scholar
  40. 40.
    Hodgkinson DJ. The olecranon bone graft for nasal augmentation. Aesthet Plast Surg. 1992;16(2):129–32.Google Scholar
  41. 41.
    Hodgkinson DJ. The Eurasian nose: aesthetic principles and techniques for augmentation of the asian nose with autogenous grafting. Aesthet Plast Surg. 2007;31(1):28–31.Google Scholar
  42. 42.
    Yanaga H, Imai K, Yanaga K. Generative surgery of cultured autologous auricular chondrocytes for nasal augmentation. Aesthet Plast Surg. 2009;33(6):795–802.Google Scholar
  43. 43.
    Fulco I, et al. Engineered autologous cartilage tissue for nasal reconstruction after tumour resection: an observational first-in-human trial. Lancet. 2014;384(9940):337–46.PubMedGoogle Scholar
  44. 44.
    Macchiarini P, et al. Clinical transplantation of a tissue-engineered airway. Lancet. 2008;372(9655):2023–30.PubMedGoogle Scholar
  45. 45.
    Shingyochi Y, Orbay H, Mizuno H. Adipose-derived stem cells for wound repair and regeneration. Expert Opin Biol Ther. 2015;15(9):1285–92.PubMedGoogle Scholar
  46. 46.
    Hanson SE, Bentz ML, Hematti P. Mesenchymal stem cell therapy for nonhealing cutaneous wounds. Plast Reconstr Surg. 2010;125(2):510–6.PubMedPubMedCentralGoogle Scholar
  47. 47.
    Akita S, et al. Noncultured autologous adipose-derived stem cells therapy for chronic radiation injury. Stem Cells Int. 2010;2010:p. 532704.Google Scholar
  48. 48.
    Jo DI, et al. Coverage of skin defects without skin grafts using adipose-derived stem cells. Aesthet Plast Surg. 2013;37(5):1041–51.Google Scholar
  49. 49.
    Altman AM, et al. IFATS collection: Human adipose-derived stem cells seeded on a silk fibroin-chitosan scaffold enhance wound repair in a murine soft tissue injury model. Stem Cells. 2009;27(1):250–8.PubMedGoogle Scholar
  50. 50.
    Romo T 3rd, Sclafani AP, Sabini P. Reconstruction of the major saddle nose deformity using composite allo-implants. Facial Plast Surg. 1998;14(2):151–7.PubMedGoogle Scholar
  51. 51.
    Ayshford CA, et al. Endoscopic repair of nasal septal perforation with acellular human dermal allograft and an inferior turbinate flap. Clin Otolaryngol Allied Sci. 2003;28(1):29–33.PubMedGoogle Scholar
  52. 52.
    Carucci JA, Kolenik SA 3rd, Leffell DJ. Human cadaveric allograft for repair of nasal defects after extirpation of Basal cell carcinoma by Mohs micrographic surgery. Dermatol Surg. 2002;28(4):340–3.PubMedGoogle Scholar
  53. 53.
    Gryskiewicz JM. Dorsal Augmentation with AlloDerm. Semin Plast Surg. 2008;22(2):90–103.PubMedPubMedCentralGoogle Scholar
  54. 54.
    Gryskiewicz JM. Waste not, want not: the use of AlloDerm in secondary rhinoplasty. Plast Reconstr Surg. 2005;116(7):1999–2004.PubMedGoogle Scholar
  55. 55.
    Gryskiewicz JM, Rohrich RJ, Reagan BJ. The use of alloderm for the correction of nasal contour deformities. Plast Reconstr Surg. 2001;107(2):561–70. discussion 571PubMedGoogle Scholar
  56. 56.
    Kridel RW, et al. Long-term use and follow-up of irradiated homologous costal cartilage grafts in the nose. Arch Facial Plast Surg. 2009;11(6):378–94.PubMedGoogle Scholar
  57. 57.
    Burke AJ, Wang TD, Cook TA. Irradiated homograft rib cartilage in facial reconstruction. Arch Facial Plast Surg. 2004;6(5):334–41.PubMedGoogle Scholar
  58. 58.
    Donald PJ, et al. The effects of irradiation dose on the stiffness of cartilage grafts. Ann Plast Surg. 1996;36(3):297–303.PubMedGoogle Scholar
  59. 59.
    Adams WP Jr, et al. The rate of warping in irradiated and nonirradiated homograft rib cartilage: a controlled comparison and clinical implications. Plast Reconstr Surg. 1999;103(1):265–70.PubMedGoogle Scholar
  60. 60.
    Raimer DW, et al. Porcine xenograft biosynthetic wound dressings for the management of postoperative Mohs wounds. Dermatol Online J. 2011;17(9):1.PubMedGoogle Scholar
  61. 61.
    Rogge MN, et al. Bovine Collagen Xenograft Repair of Extensive Surgical Scalp Wounds With Exposed Calvarium in the Elderly: Increased Rates of Wound Healing. Dermatol Surg. 2015;41(7):794–802.PubMedGoogle Scholar
  62. 62.
    Ferril GR, Wudel JM, Winkler AA. Management of complications from alloplastic implants in rhinoplasty. Curr Opin Otolaryngol Head Neck Surg. 2013;21(4):372–8.PubMedGoogle Scholar
  63. 63.
    Homicz MR, Watson D. Review of injectable materials for soft tissue augmentation. Facial Plast Surg. 2004;20(1):21–9.PubMedGoogle Scholar
  64. 64.
    Requena L, et al. Adverse reactions to injectable soft tissue fillers. J Am Acad Dermatol. 2011;64(1):1–34. quiz 35-6.PubMedGoogle Scholar
  65. 65.
    Elson ML. Injectable collagen and autoimmune disease. J Dermatol Surg Oncol. 1993;19(2):165–8. discussion 170PubMedGoogle Scholar
  66. 66.
    Sclafani AP, et al. Homologous collagen dispersion (dermalogen) as a dermal filler: persistence and histology compared with bovine collagen. Ann Plast Surg. 2002;49(2):181–8.PubMedGoogle Scholar
  67. 67.
    Moody BR, Sengelmann RD. Self-limited adverse reaction to human-derived collagen injectable product. Dermatol Surg. 2000;26(10):936–8.PubMedGoogle Scholar
  68. 68.
    Okada S, et al. Eosinophilic granulomatous reaction after intradermal injection of hyaluronic acid. Acta Derm Venereol. 2008;88(1):69–70.PubMedGoogle Scholar
  69. 69.
    Salles AG, et al. Complications after polymethylmethacrylate injections: report of 32 cases. Plast Reconstr Surg. 2008;121(5):1811–20.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Otolaryngology-Head and Neck SurgeryIzmir Bozyaka Training and Research HospitalİzmirTurkey
  2. 2.Department of Otolaryngology-Head and Neck SurgeryManisa Celal Bayar UniversityManisaTurkey
  3. 3.Department of Otolaryngology-Head and Neck SurgeryBuffalo UniversityBuffaloUSA

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