Auricular Sandwich Graft for Caudal Septal Augmentation

1986 ◽  
Vol 3 (4) ◽  
pp. 27-31
Author(s):  
Julius Newman ◽  
Abram Nguyen ◽  
Roger Anderson
Keyword(s):  
Surgical Procedure ◽  
Donor Site ◽  
Obtuse Angle ◽  
Nasal Reconstruction ◽  
Nasal Dorsum ◽  
Cartilage Graft ◽  
Nasal Tip ◽  
Aesthetic Results ◽  
Conchal Cartilage Graft ◽  
Primary Phenomenon

Retraction of columella and collapse of nasal tip may be a primary phenomenon or secondary to poor results of rhinoplasty. This may be due to excessive resection of dorsocaudal septum or inappropriate removal of the nasal spine. Reconstruction of the columella is a difficult surgical procedure and many techniques have been described. This report describes a technique of interposition of a composite skin-conchal cartilage graft between the caudal septum and columella. The graft will restore the projection of the nasal tip and correct a retracted columella by increasing its base. The newly positioned columella forms an aesthetically acceptable obtuse angle with the lip and is 2–3 mm lower than the alar rims. The cartilage from the concha of the ear is an excellent grafting material for nasal reconstruction. It has been used for augmentation of the nasal dorsum, tip grafting, and correction of vestibular atresia. The graft is harvested utilizing a technique that allows for minimal postoperative auricular deformity at the donor site. Aesthetic results have been satisfactory, with very low morbidity following this method.

Single-stage helical rim reconstruction using a post-auricular bipedicled flap

2018 ◽  
Vol 132 (11) ◽  
pp. 1022-1025
Author(s):  
D J Lin ◽  
C J Lewis ◽  
M Alrawi
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Single Stage ◽  
Reconstruction Technique ◽  
Cartilage Graft ◽  
Traditional Methods ◽  
Graft Harvest ◽  
Aesthetic Results ◽  
Conchal Cartilage Graft ◽  
Staged Operations

AbstractBackgroundMiddle-third helical rim defects may arise from trauma or oncological resection, and pose a challenging reconstructive problem. Reconstructing defects larger than 2 cm using traditional methods commits patients to the inconvenience of staged procedures.MethodThis paper describes a single-stage helical rim reconstruction technique using a post-auricular bipedicled flap and ipsilateral conchal cartilage graft for delayed middle-third helical rim reconstruction.ResultsTwo examples of this technique used in post-trauma and oncological reconstruction cases are presented, with pre- and post-operative photographs provided for demonstration.ConclusionContralateral graft harvest and staged operations for helical rim reconstruction are associated with donor site morbidity and the inconvenience of multiple operations to achieve the desired reconstructive outcome. Our single-stage helical rim reconstruction technique was well tolerated by patients, and showed satisfactory aesthetic results in terms of size and symmetry.

Repair of nasal septal perforations using local mucosal flaps and a composite cartilage graft

2001 ◽  
Vol 115 (1) ◽  
pp. 22-25 ◽  
Author(s):  
T. J. Woolford ◽  
N. S. Jones
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Observation Time ◽  
Cartilage Graft ◽  
Septal Perforation ◽  
Surgical Closure ◽  
Nasal Septal Perforation ◽  
Graft Donor ◽  
Conchal Cartilage Graft ◽  
Suitable Technique

The surgical closure of a nasal septal perforation is recognized as being particularly challenging. A series of 11 consecutive patients who underwent closure of a septal perforation using a mucosal flap/composite conchal cartilage graft technique are reviewed, and the surgical technique described. The size of the perforation repaired varied, with eight cases being 2 cm or more in diameter. There was no significant graft donor site morbidity and complete perforation closure was achieved in eight cases after a mean observation time of 19.8 months. These results suggest that this is a suitable technique for closing nasal septal perforation.

scholarly journals Cartilage Graft Donor Site Morbidity following Rhinoplasty and Nasal Reconstruction

2018 ◽  
Vol 11 (4) ◽  
pp. 278-284 ◽  
Author(s):  
Thuy-Van Tina Ho ◽  
Kevin Sykes ◽  
J.David Kriet ◽  
Clinton Humphrey
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Nasal Reconstruction ◽  
Cartilage Graft ◽  
Nasal Surgery ◽  
Auricular Cartilage ◽  
Donor Site Pain ◽  
Graft Donor ◽  
Ear Cartilage ◽  
Site Pain

Although surgical techniques for rhinoplasty and nasal reconstruction are well established, prospective research on postoperative morbidity remains limited. The aim of this pilot study was to assess costal and auricular cartilage donor site pain and morbidity in patients undergoing rhinoplasty and nasal reconstruction. In this prospective cohort study, we enrolled 55 patients undergoing nasal surgery that required costal or auricular cartilage harvest from February 2015 through May 2016. Each patient was given a symptom-specific patient survey that assessed general pain, nasal pain, graft donor site pain, graft donor site itching, color variation, skin stiffness and thickness, and graft donor site appearance at 1, 4, and 12 weeks after surgery. Our patient group was 55% female ( n = 30); the mean age was 47 years. Rib cartilage graft patients had significantly greater nasal pain than cartilage donor site pain. There was no significant difference in rib versus ear cartilage donor site pain. Nearly all patients reported that they were not at all concerned about their scar appearance or ear shape and appearance. No prior studies compare cartilage donor site morbidity in patients undergoing nasal surgery. Our findings challenge the conventional wisdom that utilizing auricular and costal cartilage results in high levels of donor site pain. Surgeons should have a low threshold to harvest rib or ear cartilage when it can improve surgical outcome.

Retroauricular skin flap and primary Z-plasty for donor site closure in partial ear reconstruction

2003 ◽  
Vol 117 (6) ◽  
pp. 487-489 ◽  
Author(s):  
Raymund E. Horch ◽  
Joerg Schipper ◽  
Roland Laszig
Keyword(s):  
Primary Closure ◽  
Skin Flap ◽  
Donor Site ◽  
Single Stage ◽  
Ear Reconstruction ◽  
Cartilage Graft ◽  
Conchal Cartilage ◽  
Primary Donor ◽  
Conchal Cartilage Graft ◽  
Donor Site Defect

Helical rim defects are noticeable and may well need reconstruction, especially in men. A method for reconstructing this type of defect together with primary donor site closure by Z-plasty is described.To close partial helical rim defects, a retroauricular caudally based rotational skin flap is performed to cover a conchal cartilage graft from the same ear that is harvested first and sutured into place to remodel the helical rim. To primarily close the donor site defect a retroauricular Z-plasty was developed which easily allowed primary closure of the donor site.The technique described here is straightforward, safe and reproducible. The Z-plasty approach for closing the donor site is useful, since the slight disturbance of the hairline is well hidden retroauricularly. This technique can be considered as a single-stage repair modality for the reconstruction of helical rim defects within primary donor site closure.

Merocel Semicompressive Dressing to Prevent Donor-Site Hematoma on the Conchal Cartilage Graft

2012 ◽  
Vol 23 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Sang Wha Kim ◽  
Chan Woo Park ◽  
Jeong Tae Kim ◽  
Youn Hwan Kim
Keyword(s):  
Donor Site ◽  
Cartilage Graft ◽  
Conchal Cartilage ◽  
Conchal Cartilage Graft

scholarly journals Aesthetic Refinements in Forehead Flap Reconstruction of the Asian Nose

2017 ◽  
Vol 25 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Yen-Chang Hsiao ◽  
Chun-Shin Chang ◽  
Jonathan Zelken
Keyword(s):  
Case Reports ◽  
Costal Cartilage ◽  
Donor Site ◽  
Free Flaps ◽  
Nasal Reconstruction ◽  
Flap Reconstruction ◽  
Forehead Flap ◽  
Aesthetic Results ◽  
The Aesthetic ◽  
Western Experience

Background: Traditional paramedian forehead flap reconstruction exploits the aesthetic subunit principle. Refinements and outcomes of forehead flap nasal reconstruction largely reflect Western experience. Differences in ethnic Asian anatomy and wound healing may foster suboptimal outcomes. We modified methods to address Asian features by extending subunit and flap boundaries, minimizing flap thinning, and overbuilding the nasal framework to combat contraction and suboptimal scarring. Methods: Between November 2010 and September 2015, 40 Asians were treated for nasal reconstruction with a modified forehead flap technique. Average age of 26 men and 14 women was 50.2 years (range: 10-87 years). Oncologic, traumatic, congenital, and infectious defects involving 1 (37%) or more (63%) subunits were reconstructed. Modifications to the classic forehead flap were extension of involved subunits and flap, conservative flap thinning, and framework overbuilding. Results: Patients were followed for 20 months (range: 16 months to 4 years 8 months). Nasal lining was reconstructed with hinge-over lining flaps, forehead flaps, free flaps, or regional flaps. Cartilage was reconstructed in 44 (88%) patients with autologous septum or ear in 33 (75%) cases. Costal cartilage was needed in 11 (25%) cases. In 48 (96%) cases, the ipsilateral forehead was used. There were 5 (10%) wound infections, 2 (4%) dehisced wounds, and 2 (4%) occurrences of distal flap necrosis. Nasal aesthetic results were 72.6% good, 23.3% fair, and 4% poor. Donor site aesthetic results were 74% good and 26% fair. Three case reports are included. Conclusion: We report favourable results of forehead flap nasal reconstruction using refinements tailored to ethnic Asians.

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