Summary
Graft selection remains a problem in nasal reconstruction, where the use of autologous
cartilage still provides the best resistance to infection and a low degree of resorption.
As the nasal septum is often absent or insufficient in such patients, the auricular
concha offers a valid alternative.
A group of 53 patients suffering from developmental iatrogenic and post-traumatic
nasal pathologies were treated surgically by means of conchal grafts. Detailed examination
of the anatomical defects presented by the patients made it possible to plan the removal
of grafts from the area of the auricular concha with great precision. Guidelines were
developed for the areas of the cymba concha and cavum concha to be used as sources
for some types of commonly used graft.
The technique described made it possible to restore the anatomically deficient structures
with satisfactory aesthetic and reconstructive results. The use of cartilage grafts
also addressed functional breathing problems.
The auricular concha is easy to shape and can provide grafts to reconstruct the various
anatomical components of the nasal pyramid. To this end, it proves very useful to
save as much cartilage as possible and to pinpoint affinities between some areas of
the concha and the structures to be reconstructed.
Keywords
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References
- Revision rhinoplasty.Facial Plast Surg. 2003; 19: 299-307
- Expanded polytetrafluoroethylene implants in rhinoplasty: literature: review, operative techniques, and outcomes.Facial Plast Surg. 2003; 19: 331-339
- Augmentation rhinoplasty: observation on 1200 cases.Plast Reconstr Surg. 1991; 87: 54-59
- Rinoplastica: lo stato dell'arte.EdiSES S.r.l., Napoli1999
- Implants in rhinoplasty.Facial Plast Surg. 1997; 13: 279-290
- Structural grafting in rhinoplasty.Facial Plast Surg. 2002; 18: 223-232
- Auricular cartilage in revision rhinoplasty.Facial Plast Surg. 2003; 19: 41-51
- Upper lateral cartilage suspension over dorsal grafts: a treatment for internal nasal valve dynamic incompetence.Facial Plast Surg. 1999; 15: 309-316
- The relative importance of septal and nasal valvular surgery in correcting airway obstruction in primary and secondary rhinoplasty.Plast Reconstr Surg. 1996; 98: 38-53
- Achieving more nasal tip projection by the use of a small autogenous vomer or septal cartilage graft.Plast Reconstr Surg. 1975; 56: 35-40
- The onlay graft for nasal tip projection.Plast Reconstr Surg. 1983; 71: 27-37
- Management of deformities of the lower cartilaginous vault.Arch Otolaryngol. 1951; 54: 467-472
- Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty.Plast Reconstr Surg. 1984; 73: 230-237
- Use of alar batten graft for correction of nasal collapse.Arch Otolaryngol Head Neck Surg. 1997; 123: 802-808
- Subtotal reconstruction of the nasal septum using a conchal reshaped graft.Ann Plast Surg. 2004; 53: 118-125
- Augmentation rhinoplasty using an L-shaped auricular cartilage framework combined with dermal fat graft for cleft lip nose.Aesthetic Plast Surg. 1999; 23: 107-112
- Collapsed alae strengthened by conchal cartilage (the butterfly cartilage graft).Br J Plast Surg. 1965; 18: 92-96
- Ear cartilage grafts to the nose.Plast Reconstr Surg. 1979; 63: 377-382
- The bilateral conchal cartilage graft: a new technique in augmentation rhinoplasty.Aesthetic Plast Surg. 1984; 8: 37-42
- Structural grafting in rhinoplasty.Facial Plast Surg. 1997; 13: 269-277
- Cartilage grafts in open rhinoplasty.Facial Plast Surg. 1993; 9: 285-294
- Combined conchal cartilage–ethmoid bone grafts in nasal surgery.Plast Reconstr Surg. 2000; 106: 171-175
- Revision rhinoplasty for monographs in facial plastic surgery contemporary rhinoplasty.Facial Plast Surg. 1997; 13: 299-308
Article info
Publication history
Published online: May 28, 2006
Accepted:
February 8,
2006
Received:
August 5,
2005
Footnotes
☆This study was presented at the XIV National Meeting of Italian Society of Maxillo-Facial Surgery, 2005 June 9–11.
Identification
Copyright
© 2006 The British Association of Plastic Surgeons. Published by Elsevier Inc. All rights reserved.