Perichondrial Attached Diced Cartilage (PADC), a Novel Graft Material for Nasal Augmentation: 10 Years of Experience

2021 ◽  
Author(s):  
Abbas Kazemi Ashtiani ◽  
Mohammad Reza Moghimi ◽  
Farhad Hafezi
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Septal Cartilage ◽  
Graft Material ◽  
Successful Operation ◽  
Dorsal Nasal Augmentation ◽  
New Material ◽  
Surgical Field ◽  
Diced Cartilage ◽  
Nasal Augmentation

Abstract Background Using onlay graft for dorsal augmentation is a challenging procedure. Visibility and warping of grafted cartilages can ruin an otherwise successful operation. A shortage of septal cartilage and rib donor site morbidity compounds the problems of this procedure. Objectives Our objectives were to find an autologous material for dorsal nasal augmentation which does not disperse upon implementation. It also should have minimal resorption, lack of warping and no need for wrapping membrane. Methods In 30 patients, concha cartilage of the ear with attached perichondrium and fascia were removed. The concha cartilage was diced while it was attached to the posterior soft tissue. The purpose was to develop graft material for dorsal augmentation. Results In an average of 19.56 months follow-up, no sign of resorption, infection, inflammation, volume loss, or displacement of the grafted material was noticed. Aesthetically the results were acceptable and most of the patients were satisfied with the outcome. Conclusions Perichondrial attached diced cartilage (PADC) is a new material for the rhinoplasty surgeon to apply in different onlay nasal augmentation procedures in the unduly reduced nasal dorsum. This technique transforms an uneven peculiar-shaped concha cartilage to flexible, versatile, and durable material. The donor site is in the surgical field and easy to access.

Cartilage Scales Embedded in Fibrin Gel

2017 ◽  
Vol 33 (02) ◽  
pp. 225-232 ◽  
Author(s):  
Milos Kovacevic ◽  
Frank Riedel ◽  
Jochen Wurm ◽  
Gregor Bran
Keyword(s):  
Regenerative Medicine ◽  
Surgical Techniques ◽  
Fibrin Gel ◽  
Platelet Rich Fibrin ◽  
Preliminary Results ◽  
Advantages And Disadvantages ◽  
The Past ◽  
Dorsal Nasal Augmentation ◽  
Diced Cartilage ◽  
Nasal Augmentation

Multiple techniques have been described for dorsal nasal augmentation in rhinoplasty. In this article, we review common surgical techniques for raising the dorsum or eliminating dorsal irregularities, by highlighting inherent advantages and disadvantages of each method. Within the past few years, the use of diced cartilage grafts has become the workhorse in this field of interest. To overcome drawbacks of methods based on diced cartilage, we present a new concept for autologous augmentation, using regenerative medicine protocols. A mix of cartilage scales with cartilage pâté was embedded in platelet-rich fibrin (PRF). Since December 2015, a total of 48 patients were treated with this technique. Based on our preliminary results, cartilage scales in PRF appear to be a promising and reliable alternative to existing procedures for dorsal nasal augmentation.

The Sternocleidomastoid Myocutaneous Flap: A Laryngeal Preservation Option for Total Hypopharyngoesophageal Stenosis

2019 ◽  
Vol 161 (1) ◽  
pp. 186-189 ◽  
Author(s):  
Hassan Paknezhad ◽  
Nicole A. Borchard ◽  
Gordon K. Lee ◽  
Edward J. Damrose
Keyword(s):  
Donor Site ◽  
Case Series ◽  
Oral Intake ◽  
Donor Site Morbidity ◽  
Retrospective Case ◽  
Endoscopic Techniques ◽  
Laryngeal Preservation ◽  
Cosmetic Outcomes ◽  
Surgical Field ◽  
Pharyngeal Reconstruction

Complete hypopharyngoesophageal (HPE) stenosis is rare and a challenging condition to treat. When endoscopic therapy fails, total laryngectomy with or without pharyngeal reconstruction is usually performed. We present a retrospective case series involving 3 patients with complete HPE stenosis who failed endoscopic repair and were gastrostomy dependent. All were managed successfully with the sternocleidomastoid myocutaneous (SCM) flap. A temporary fistula occurred in 1 patient. Hospitalization ranged from 5 to 15 days, patients resumed oral intake from 21 to 82 days postoperatively, and their gastrostomy tubes were removed from 28 to 165 days postoperatively. We suggest that the SCM flap is a laryngeal preservation option for reconstruction of complete HPE stenosis when endoscopic techniques fail. This flap allows HPE repair and reconstruction within the same surgical field, imposes no significant donor site morbidity, and affords good functional and cosmetic outcomes.

Versatility of Diced Cartilage–Fascia Grafts in Dorsal Nasal Augmentation

2007 ◽  
Vol 120 (6) ◽  
pp. 1654-1659 ◽  
Author(s):  
Martin H. Kelly ◽  
Neil W. Bulstrode ◽  
Norman Waterhouse
Keyword(s):  
Dorsal Nasal Augmentation ◽  
Diced Cartilage ◽  
Nasal Augmentation

Composite Cartilage-osseous-mucosal Nasoseptal Flap for Reconstruction after Near Total Rhinectomy

2020 ◽  
Vol 130 (1) ◽  
pp. 98-103
Author(s):  
Karthik S. Shastri ◽  
Yufan Lin ◽  
Jessica Scordino ◽  
Carlos D. Pinheiro-Neto
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Septal Cartilage ◽  
Nasal Reconstruction ◽  
Full Thickness ◽  
Nasoseptal Flap ◽  
Nasal Defect ◽  
Skin Envelope ◽  
Upper Lateral Cartilage ◽  
Nasal Defects

Background: Reconstruction of full thickness nasal defects usually requires different donor sites for the external skin envelope, structural elements, and internal nasal lining. In this paper we present a novel single site method for dual inner lining and skeleton repair for full thickness nasal defects with a composite nasoseptal flap and extended pedicle dissection. Methods: A 72-year-old male presented with a T4b melanoma involving the nasal dorsum and left upper lateral cartilage. Following full thickness resection, reconstruction was performed with a nasoseptal flap (NSF) with attached septal cartilage and vomer in conjunction with a paramedian forehead flap. Extended pedicle dissection into the pterygopalatine fossa allowed the NSF to fully cover the defect. Results: The nasal defect was fully corrected. There was no evidence of flap compromise or nasal valve stenosis at 1 month, 2 month, and 1 year follow-up visits. Conclusions: We present here the first successful application of a composite cartilage-osseous-mucosal NSF for multilayered nasal reconstruction. In appropriate patients, this technique may obviate the need for flaps or grafts from extranasal sources, limiting donor site morbidity.

Calvarial bone grafts for augmentation rhinoplasty

1991 ◽  
Vol 105 (12) ◽  
pp. 1018-1020 ◽  
Author(s):  
Brajendra Baser ◽  
Rekha Shahani ◽  
Shalini Khanna ◽  
D. S. Grewal
Keyword(s):  
Biological Material ◽  
Donor Site ◽  
Bone Grafts ◽  
Donor Site Morbidity ◽  
Modern Trend ◽  
Saddle Nose ◽  
Graft Material ◽  
Augmentation Rhinoplasty ◽  
Calvarial Bone

AbstractA large variety of graft materials have been used for augmentation rhinoplasty. To date there has been no graft material which can be regarded as completely satisfactory. The modern trend is to prefer autologous material to new biological material. The membranous bones of the calvarium are extremely suitable for augmenting moderate to severe saddle nose deformities. Calvarial bone grafts can be harvested easily, with minimum donor site morbidity and disfigurement. Our experience with calvarial bone grafts for augmentation rhinoplasty is presented.

scholarly journals The Use of Mastoid Fascia for Dorsal Nasal Augmentation

2017 ◽  
Vol 90 (3) ◽  
pp. 294-304
Author(s):  
Ahmed Hassan El-Sabbagh
Keyword(s):  
Reliable Method ◽  
Donor Site ◽  
Digital Photography ◽  
Potential Site ◽  
Dorsal Nasal Augmentation ◽  
Post Traumatic ◽  
Nasal Augmentation

Background and aim. Dorsal augmentation of the nose is needed after trauma, rhinoplasty or for ethnic reasons. Alloplastic or autogenous materials may be used. In this paper, postauricular mastoid fascia was used for dorsal nasal augmentation. Methods. This study included ten patients who underwent dorsal nasal augmentation. Fascia over mastoid area was taken in all cases and was fixed with Steri-Strips and external nasal splints.Results. All patients were female except one case. Five patients had the operation because of ethnic causes and five patients did the operation due to post traumatic deformity. Donor sites healed uneventfully. Digital photography was taken to assess the grafts and follow up was extended up to 9 months.Conclusions. Mastoid fascia is a reliable method and its donor site is hidden. In addition, it can be a potential site for conchal graft if needed.

Diced Cartilage Grafts Wrapped in AlloDerm for Dorsal Nasal Augmentation

2011 ◽  
Vol 22 (4) ◽  
pp. 1196-1199 ◽  
Author(s):  
Chad R. Gordon ◽  
Mohammed Alghoul ◽  
Jonathan S. Goldberg ◽  
Mutaz B. Habal ◽  
Francis Papay
Keyword(s):  
Cartilage Grafts ◽  
Dorsal Nasal Augmentation ◽  
Diced Cartilage ◽  
Nasal Augmentation

scholarly journals Investigation Into the Optimal Number of Intercostal Nerve Transfers for Musculocutaneous Nerve Reinnervation: A Systematic Review

Hand ◽  
2017 ◽  
Vol 13 (6) ◽  
pp. 621-626 ◽  
Author(s):  
Hyuma A. Leland ◽  
Beina Azadgoli ◽  
Daniel J. Gould ◽  
Mitchel Seruya
Keyword(s):  
Systematic Review ◽  
Brachial Plexus ◽  
Donor Site ◽  
Elbow Flexion ◽  
Donor Site Morbidity ◽  
Intercostal Nerve ◽  
Optimal Number ◽  
Musculocutaneous Nerve ◽  
Nerve Transfers ◽  
Meta Analyses

Background: The purpose of this study was to systematically review outcomes following intercostal nerve (ICN) transfer for restoration of elbow flexion, with a focus on identifying the optimal number of nerve transfers. Methods: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify studies describing ICN transfers to the musculocutaneous nerve (MCN) for traumatic brachial plexus injuries in patients 16 years or older. Demographics were recorded, including age, time to operation, and level of brachial plexus injury. Muscle strength was scored based upon the British Medical Research Council scale. Results: Twelve studies met inclusion criteria for a total of 196 patients. Either 2 (n = 113), 3 (n = 69), or 4 (n = 11) ICNs were transferred to the MCN in each patient. The groups were similar with regard to patient demographics. Elbow flexion ≥M3 was achieved in 71.3% (95% confidence interval [CI], 61.1%-79.7%) of patients with 2 ICNs, 67.7% (95% CI, 55.3%-78.0%) of patients with 3 ICNs, and 77.0% (95% CI, 44.9%-93.2%) of patients with 4 ICNs ( P = .79). Elbow flexion ≥M4 was achieved in 51.1% (95% CI, 37.4%-64.6%) of patients with 2 ICNs, 42.1% (95% CI, 29.5%-55.9%) of patients with 3 ICNs, and 48.4% (95% CI, 19.2%-78.8%) of patients with 4 ICNs ( P = .66). Conclusions: Previous reports have described 2.5 times increased morbidity with each additional ICN harvest. Based on the equivalent strength of elbow flexion irrespective of the number of nerves transferred, 2 ICNs are recommended to the MCN to avoid further donor-site morbidity.

scholarly journals Use of Gracile and semi-tendinosus tendons (GRAST) for the reconstruction of irreparable rotator cuff tears

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marie Protais ◽  
Maxime Laurent-Perrot ◽  
Mickaël Artuso ◽  
M. Christian Moody ◽  
Alain Sautet ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Donor Site ◽  
Anatomical Study ◽  
Donor Site Morbidity ◽  
Rotator Cuff Tears ◽  
Subacromial Space ◽  
Greater Tuberosity ◽  
Working Zone ◽  
Superior Capsular Reconstruction

Abstract Background Irreparable rotator cuff tears are common and difficult to treat. Techniques for “filling the loss of substance” require fixation to the rotator cuff stump (tendon augmentation) or to the glenoid (superior capsular reconstruction), which are complicated by the narrow working zone of the subacromial space. The main objective of this study was to determine whether a braided graft of gracilis (GR) and semitendinosus (ST) could fill a loss of tendon substance from an irreparable rupture of the supra- and infraspinatus, by fixing the graft to the greater tuberosity and the spine of the scapula. Methods This was a cadaveric study with the use of ten specimens. The GRA and ST tendons were harvested, braided and reinforced with suture. An experimental tear of the supraspinatus (SS) and upper infraspinatus (IS) retracted at the glenoid was made. The GRAST transplant was positioned over the tear. The transplant was attached to the greater tuberosity by two anchors and then attached to the medial third of the scapular spine by trans-osseous stitching. The percentage of filling obtained was then measured and passive mobility of the shoulder was assessed. We proceeded to the same technique under arthroscopy for a 73 years old patient whom we treated for a painful shoulder with irreparable cuff tear. We inserted a GRAST graft using arthroscopy. Results The Braided-GRAST allowed a 100% filling of the loss of tendon substance. Mobility was complete in all cases. Conclusion This technique simplifies the medial fixation and restores the musculo-tendinous chain where current grafting techniques only fill a tendinous defect. The transplant could have a subacromial “spacer” effect and lower the humeral head. The donor site morbidity and the fate of the transplant in-vivo are two limits to be discussed. This anatomical study paves the way for clinical experimentation.

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