Replacement of the Nasal Dorsum with a Diced Cartilage Glue Graft

2019 ◽  
Vol 35 (01) ◽  
pp. 053-057 ◽  
Author(s):  
Abel-Jan Tasman
Keyword(s):  
Fibrin Glue ◽  
Clinical Case ◽  
Nasal Dorsum ◽  
Nasal Bones ◽  
Hump Resection ◽  
Diced Cartilage

AbstractThe reconstruction of the nasal dorsum after a hump resection is challenging if narrowing of the nose is to be avoided, the nasal skin is very thin, and the nasal bones are short. This report describes the replacement of the bony and cartilaginous nasal dorsum after resection with an anatomically shaped dorsal replacement graft of diced cartilage in fibrin glue. The technique is illustrated with a clinical case and sonographic morphometry of the nasal dorsum and tip. A modification of the diced cartilage glue graft for thin-skinned patients is presented.

Dorsal Augmentation-Diced Cartilage Techniques: The Diced Cartilage Glue Graft

2017 ◽  
Vol 33 (02) ◽  
pp. 179-188 ◽  
Author(s):  
Abel-Jan Tasman
Keyword(s):  
Fibrin Glue ◽  
Nasal Dorsum ◽  
Autologous Tissue ◽  
Ideal Method ◽  
Diced Cartilage ◽  
Nasal Augmentation ◽  
Over Time ◽  
The Ideal

The quest for the ideal method for augmenting the nasal dorsum continues to be a matter of debate, with both most surgeons and patients preferring autologous tissue. This article reviews the current use of diced cartilage for nasal augmentation, emphasizing the diced cartilage in fibrin glue (DCG) graft. It offers the first collation of unfavorable outcomes and complications of the DCG graft seen in a series of 108 patients treated at the author's institution. The DCG graft continues to be a versatile graft that is stable over time and combines unique features. It has proved to be particularly well suited for segmental augmentations of the dorsum. Resorption of the graft has been rare and infrequent unfavorable outcomes have all been amenable to successful minor surgical revisions.

Rhinoplasty: Aesthetic Augmentation With Improvement of Dorsal Aesthetic Lines

2021 ◽  
Author(s):  
Vitaly Zholtikov ◽  
Vladimir Golovatinskii ◽  
Riadh Ouerghi ◽  
Rollin K Daniel
Keyword(s):  
Single Layer ◽  
Essential Elements ◽  
Rectus Abdominis ◽  
Nasal Dorsum ◽  
Wide Spread ◽  
Temporalis Fascia ◽  
Temporal Fascia ◽  
Layer 2 ◽  
Diced Cartilage

Abstract Background Camouflage of nasal dorsum, aesthetic augmentation and highlighting the dorsal aesthetic lines are essential elements in modern rhinoplasty. Numerous techniques have been utilized including deep temporal fascia, rectus abdominis fascia, and diced cartilage in fascia (DC-F). Despite their wide spread adoption, technical challenges remained, especially when utilized for aesthetic purposes. Objectives The paper details the use of fascia (F) and diced cartilage in fascia grafts (DC-F) for aesthetic dorsal refinement in primary and secondary cases. One of the main goals was to achieve ideal dorsal aesthetic dorsal lines rather than just volume augmentation. Methods We used grafts from the deep temporalis fascia (F) and rectus abdominis fascia (RF) in 4 configurations: 1) single layer, 2) double layer, 3) full length diced cartilage in fascia grafts (DC-F), and 4) partially filled – segmental DC-F grafts. Technical refinements included careful determination of dimensions and meticulously suturing to the dorsum at appropriately 10 points to prevent graft displacement. Results We report our experience: 146 clinical cases over 35 months from January 2017 to December 2019. The patients were divided for 4 groups depending on which type of graft was used. Conclusions Use of autogenous deep temporal fascia, rectus abdominis fascia, and diced cartilage in fascia (DC-F) to camouflage dorsal irregularities, to highlight dorsal aesthetic lines, and to aesthetically augment either the entire nasal dorsum or its individual parts. Optimization of cutting, stitching, filling the graft, careful fixation of these grafts on the nasal dorsum, significantly increases the predictability of these techniques and minimizes problems.

Bone Chips and Diced Cartilage: An Anatomically Adopted Graft for the Nasal Dorsum

2004 ◽  
Vol 28 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Muzaffer Çelik ◽  
Tamer Haliloğlu ◽  
Nazmi Bayçın
Keyword(s):  
Nasal Dorsum ◽  
Diced Cartilage

Refining the Nasal Dorsum with Free Diced Cartilage

2016 ◽  
Vol 32 (04) ◽  
pp. 345-350 ◽  
Author(s):  
Wolfgang Gubisch ◽  
Christian Kreutzer ◽  
Sebastian Haack ◽  
Julius Hoehne
Keyword(s):  
Nasal Dorsum ◽  
Diced Cartilage

Congenital Dorsal Nasal Dysplasia: An Autosomal Dominant Aplasia or Hypoplasia of Nasal Bones and Hyperplasia of the Cartilaginous Nasal Dorsum That Can Be Reconstructed Safely by an Open Approach

1995 ◽  
Vol 12 (1) ◽  
pp. 21-30
Author(s):  
Stuart H. Bentkover ◽  
Philip L. Townes ◽  
Beth Kozlicak
Keyword(s):  
Structural Integrity ◽  
Autosomal Dominant ◽  
Family Members ◽  
Open Approach ◽  
Nasal Dorsum ◽  
Radiographic Findings ◽  
Characteristic Appearance ◽  
Nasal Bones ◽  
Two Generations ◽  
Operative Findings

Aplasia or hypoplasia of the nasal bones has been reported infrequently, and at least three reports demonstrate an autosomal dominant inheritance. These noses share a characteristic appearance indicative of an inherited dysplasia of not just the nasal bones (aplasia or hypoplasia) but also the cartilaginous dorsum (hyperplasia). We studied a 42-year-old woman and her father with aplastic and hypoplastic nasal bones, respectively, and some other family members in two generations. Radiographic findings, family history, photographs of other family members, and operative findings are discussed. Their nasal anomalies probably result from a variably expressed autosomal dominant trait affecting the development of the nasal bones and cartilages in a very characteristic manner. We call this anomaly congenital dorsal nasal dysplasia. In noses without nasal bones, the open approach optimizes surgical visualization in an effort to maximize the structural integrity of the septum and nasal dorsum. The quadrilateral cartilage–upper lateral cartilage unit provides most of the dorsal support to the upper two-thirds of these unusual noses and should be meticulously reconstructed. Gore-Tex® Soft Tissue Patch is useful for dorsal augmentation of the deep nasofrontal angle often found in these noses and for camouflage of irregularities.

A Systematic Review and Meta-Analysis of Complications Associated With Autogenous Diced Cartilage Wrapped in Fascia Used in Nasal Dorsum Augmentation

2021 ◽  
Author(s):  
Seied Omid Keyhan ◽  
Shaqayeq Ramezanzade ◽  
Behnam Bohluli ◽  
Hamid Reza Fallahi ◽  
Madjid Shakiba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Donor Site ◽  
Reference List ◽  
Complication Rates ◽  
Nasal Dorsum ◽  
Level Of Evidence ◽  
Recipient Site ◽  
Diced Cartilage

Abstract Background Nasal dorsum augmentation is a highly challenging rhinoplastic procedure. Problems encountered in this surgery, such as residual humps, irregularities, and asymmetry, account for a significant number of revision rhinoplasties. Objectives The aim of this meta-analysis was to assess complication rates and graft harvesting site morbidity and revision rates. Methods We carried out a systematic review of the literature for pertinent materials in PubMed/Medline and Google Scholar up to and including August 2020. In addition, the reference list of included studies was searched manually. The criteria used were those described in the PRISMA Declaration for performing systematic reviews. Results The initial search yielded 236 results. After 3 stages of screening, 16 papers (18 groups) were included in the systematic review and meta-analysis. Our results indicated that the total rates for the complications studied were as follows: graft resorption, 2.52%; insufficient augmentation, 3.93%; deviation (graft displacement), 1.77%; infection, 2.30%; irregularity, 1.36%; supra-tip depression, 1.13%; overcorrection, 3.06%; hematoma at recipient site, 1.36%; and visible bulging of the graft, 2.64%. The total rates for donor site hypertrophic scar and donor site hematoma were 2.64% and 3.58%, respectively. The rate of the revision surgery was 3.03%. Conclusions Current findings suggest the overall complications and revision rates with the use of diced cartilage wrapped in fascia for dorsum augmentation were relatively low and this technique is a reliable treatment choice for patients with primary/secondary dorsum deficiencies. Further studies with larger sample sizes and long-term follow-ups, clearer definitions of complications, and objective measurements are warranted to draw reliable practical conclusions. Level of Evidence: 4

scholarly journals Modified perichondrial-periosteal flaps to camouflage nasal dorsum in rhinoplasty

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Ahmed Gamal Khafagy ◽  
Hesham Abdelaty El-Sersy ◽  
Ahmed Mahmoud Maarouf
Keyword(s):  
Nasal Obstruction ◽  
Lateral Cartilage ◽  
Nasal Dorsum ◽  
Nasal Breathing ◽  
Periosteal Flap ◽  
Nasal Bones ◽  
Upper Lateral Cartilage ◽  
Successful Technique ◽  
Hump Reduction

Abstract Background The smooth and straight nasal dorsum is a goal after nasal hump reduction as dorsal irregularities are unexpectable and inevitable complications. The aim of this study is to evaluate modified perichondrial-periosteal flaps functionally and aesthetically to camouflage nasal dorsal irregularities. A total of 115 patients with nasal humps were enrolled in the study. The perichondrium over the upper lateral cartilages is divided in the midline and dissected forming two laterally based flaps while the periosteum over the nasal bones is dissected superiorly. After completion of all rhinoplasty steps, the flaps were repositioned and sutured as a separate layer. Follow-up for 2 years with an assessment of irregularities of the nasal dorsum, collapse of the upper lateral cartilage, and nasal breathing. Results Aesthetically, no nasal dorsal irregularities were noticed. Also, no patients complained of nasal obstruction. Conclusion The modified perichondrial-periosteal flap is a successful technique, functionally and aesthetically. It avoids the appearance of dorsal irregularities.

Use of absorbable membrane in diced cartilage technique for nasal dorsum restoration

2020 ◽  
Vol 73 (12) ◽  
pp. 2239-2260
Author(s):  
Pasquale Piombino ◽  
Pamela Zace ◽  
Luigi Angelo Vaira ◽  
Giacomo De Riu ◽  
Luigi Califano
Keyword(s):  
Nasal Dorsum ◽  
Diced Cartilage
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