Cadaveric Costal Cartilage Grafts in Rhinoplasty and Septorhinoplasty

In the graft depleted revision rhinoplasty patient and the patient with major tissue needs, alternatives to septal and conchal cartilage grafts are needed. The costal cartilage graft and rib bone/costal cartilage combination graft are excellent alternatives. In this study 14 patients received 40 grafts from 20 autogenous ribs harvested during septorhinoplasty. Materials were harvested for use as septal replacement grafts, cantilevered grafts, dorsal onlay grafts, columellar struts, and tip grafts. Patient followup was 6 to 31 months, and no evidence of graft resorption or warpage was evident during that period. Complications of harvest were minimal, and harvest techniques are detailed.

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Dorsal Augmentation of Saddle Nose Deformity With Toothpick-Shaped Costal Cartilage Grafts in the Secondary Septorhinoplasty

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000004032 ◽

2017 ◽

Vol 28 (8) ◽

pp. 2063-2065 ◽

Cited By ~ 3

Author(s):

Raşit Cevizci ◽

Selin Üstün Bezgin ◽

Burak Ömür Çakir ◽

Burak Kersin ◽

Yildirim Ahmet Bayazit

Keyword(s):

Costal Cartilage ◽

Saddle Nose ◽

Cartilage Grafts ◽

Saddle Nose Deformity ◽

Nose Deformity

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One-stage reconstruction of a tracheal defect with a free radial forearm flap and free costal cartilage grafts

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2013.12.053 ◽

2014 ◽

Vol 67 (6) ◽

pp. 857-859 ◽

Cited By ~ 6

Author(s):

Yutaka Fukunaga ◽

Minoru Sakuraba ◽

Shimpei Miyamoto ◽

Shuji Kayano ◽

Koreyuki Kurosawa ◽

...

Keyword(s):

Costal Cartilage ◽

Radial Forearm Flap ◽

Cartilage Grafts ◽

Forearm Flap ◽

One Stage ◽

Free Radial Forearm Flap ◽

Tracheal Defect ◽

Radial Forearm ◽

One Stage Reconstruction

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Use of 2-Octylcyanoacrylate (Dermabond) Tissue Adhesive for Tip Graft Fixation in Open Rhinoplasty

Otolaryngology ◽

10.1177/0194599811419094 ◽

2011 ◽

Vol 145 (5) ◽

pp. 737-741 ◽

Cited By ~ 7

Author(s):

Jin-Young Min ◽

Yong Ju Jang

Keyword(s):

Complication Rate ◽

Soft Tissues ◽

Costal Cartilage ◽

Tertiary Care ◽

Case Series ◽

Tissue Adhesive ◽

Open Rhinoplasty ◽

External Approach ◽

Cartilage Grafts ◽

Nasal Tip

Objectives. To describe the use of 2-octylcyanoacrylate (2-OCA; Dermabond) for fixation of cartilage grafts in nasal tip surgery via an external approach in Asian patients. Study Design. Case series with chart review. Setting. Academic tertiary care medical center. Subjects and Methods. This retrospective study analyzed data from 33 Korean patients who underwent open rhinoplasty using 2-OCA tissue adhesive for fixation of cartilage grafts in tip surgery. Autologous septal, conchal, costal, or homologous costal cartilage was used as graft materials. Layers of cartilages were bonded using 2-OCA tissue adhesive, and care was taken to prevent the tissue adhesive from spilling and directly contacting surrounding soft tissues. Preoperative and postoperative photographs were reviewed for objective and subjective assessment of aesthetic outcomes. Results. Postoperative aesthetic outcomes were graded as excellent in 51.5%, fair in 33.3%, and no change/worse in 15.2% of patients. Preoperative and postoperative anthropometric measurements showed that the nasal tip projection increased (0.53 ± 0.03 vs 0.57 ± 0.05; P < .05) and the nasolabial angle improved (92.54 ± 6.95 vs 96.12 ± 5.20; P < .05). The overall complication rate was 24.2%, and complications included erythema (9.1%), infection (12.1%), and aesthetic dissatisfaction (3.0%). Conclusion. Although using 2-OCA tissue adhesive for tip surgery simplifies the surgical procedures of fixating graft materials, the relatively high complication rate may preclude its use in nasal tip surgery via an external approach for Asian noses.

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Arthroplasty of the Proximal Interphalangeal Joint Using Costal Cartilage Grafts

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(05)80248-7 ◽

1992 ◽

Vol 17 (5) ◽

pp. 583-585 ◽

Cited By ~ 68

Author(s):

T. HASEGAWA ◽

Y. YAMANO

Keyword(s):

Costal Cartilage ◽

Proximal Phalanx ◽

Functional Results ◽

Clinical Results ◽

Proximal Interphalangeal Joint ◽

Range Of Movement ◽

Cartilage Grafts ◽

Articular Fractures ◽

Pip Joint ◽

Bony Ankylosis

Seven intra-articular fractures in five patients with partial bone loss at the PIP joint were reconstructed using a graft of costal cartilage. In all cases there were total or partial cartilagenous defects of the proximal phalangeal side of the joint. Early treatment of two joints, using only costal cartilage grafts, resulted in bony ankylosis due to necrosis of the grafted cartilage. In five joints the grafted cartilage included osseous portions using the costo-osteochondral junction, leading to an average range of movement of 64° with satisfactory clinical results. The technique is a useful alternative to other forms of arthroplasty or arthrodesis, and can provide satisfactory functional results when there is a partial defect of the head of the proximal phalanx.

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Nasal correction in nasomaxillary hypoplasia (Binder’s syndrome): An optimised classification and treatment

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.197237 ◽

2016 ◽

Vol 49 (03) ◽

pp. 314-321 ◽

Cited By ~ 1

Author(s):

Venkata Ramana Yamani ◽

Shakuntala Ghosh ◽

Shreekumar Tirunagari

Keyword(s):

Costal Cartilage ◽

Functional Results ◽

En Bloc ◽

Cartilage Grafts ◽

Long Term Stability ◽

Alar Base ◽

Rare Congenital Disorder ◽

Nasal Floor ◽

The Individual

ABSTRACT Background: Nasomaxillary hypoplasia is a rare congenital disorder involving the central face. It imparts a distinctive appearance to the individual face as the age advances. Severity of the disorder varies, so do the manifestations. Methods: This was a retrospective study conducted on the records and photographic data of 560 rhinoplasty cases performed between 2006 March and 2016 March. About 16 cases of nasomaxillary hypoplasia were selected from the group and they were classified based on the severity of the features. Surgical correction performed in each group was detailed. Results: Three percent of the 560 rhinoplasties performed in our centre turned out to be cases of Binder's syndrome. Nasal correction with locoregional autologous cartilage grafts was sufficient in mild cases. Loco-regional cartilage grafts along with costal cartilage grafts were needed for moderate and severe cases. Anterior nasal floor along with alar base augmentation was performed to achieve a proper aesthetic profile in moderate and severe cases. Post-operative results were excellent in mild and moderate cases and acceptable in severe cases. Discussion: We attempted to correct the deformity only after growth of the nose and maxilla was completed. We used cartilage grafts as a mainstay as cartilage has long-term stability without resorption unlike bone grafts. Instead of following en bloc technique of cartilage assembly, we have reconstructed the nasal dorsum, columella and tip separately as this principle is more functionally acceptable with less warping or stiffness of the nose. Importance was given to proper anchorage of grafts. Conclusion: We have attempted to put together the various features into three categories of mild/moderate/severe based on previous anthropometric studies of nasal anatomical parameters. The second objective of our study was to advise a logical surgical protocol for each group so that future surgeons can follow an easy surgical guideline to attain optimal cosmetic and functional results.

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Y-Shaped En-Bloc Mortise-Tenon Rhinoplasty Technique

Aesthetic Surgery Journal ◽

10.1093/asj/sjz120 ◽

2019 ◽

Vol 40 (1) ◽

pp. NP8-NP20 ◽

Cited By ~ 1

Author(s):

Zheng Tan ◽

Wentao Sun ◽

Wenjing Yang ◽

Xiaoling Zhu ◽

Fan Dong ◽

...

Keyword(s):

Costal Cartilage ◽

Septal Cartilage ◽

The Novel ◽

En Bloc ◽

Level Of Evidence ◽

Cartilage Grafts ◽

Asian Patients ◽

Caudal Portion ◽

Aesthetic Results ◽

Nose Deformity

AbstractBackgroundNasal tip management is the most important and challenging aspect of rhinoplasty. Costal cartilage can be utilized in septal extension grafting to effectively correct nasal shape deformity.ObjectivesThe authors described their experience with costal cartilage grafting for septal extension utilizing a novel en-bloc mortise-tenon technique to correct primary or secondary nose deformity or to enhance nasal appearance in Asian patients.MethodsFrom July 2015 to December 2017, costal cartilage grafts were applied as septal extension biomaterials utilizing the novel en-bloc mortise-tenon technique in 278 consecutive Asian rhinoplasty patients with primary (n = 95), secondary (n = 173), and tertiary (n = 10) nose deformity or in patients needing nasal reshaping. The age of the patients ranged from 19 to 46 years. In all cases, the mucoperichondria of the nasal septum were dissected bilaterally from the septal cartilage. The prepared en-bloc costal cartilage graft was mounted onto the caudal portion of the septal cartilage and fixed to the septum with 5-0 polydioxanone sutures.ResultsThe follow-up duration ranged from 10 months to 2.5 years. Of the 278 patients treated, 5 were male and 273 were female. External lengthening of the nose from the nasal root to the tip ranged from 3 to 10 mm. All patients except 1 were satisfied with the shape of the nose.ConclusionsThe authors obtained good aesthetic results utilizing the novel en-bloc mortise-tenon method for connecting costal cartilage grafts as septal extension materials in patients with different types of nasal deformity and in patients needing nose reshaping.Level of Evidence: 4

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