Bone Grafts for Nasal Reconstruction

Bone Framework Graft through an Intraoral Approach in a Patient with Columellar Scar Contracture

“…Autologous and homologous cartilages have proven to be more efficient in the correction of minor deficiencies of the columella, nasal dorsum, and nasal tip. However, these are inadequate for major bony defects that require structural reconstruction due to the limited size of the cartilage, unpredictable resorption rates, and their inability to achieve fixation to the underlying bone [5]. Autogenous calvarial grafts were used in the 1890s as part of an osteocutaneous flap by König and Müller.…”

Biological Spare Part Surgery Applied to Nasal Reconstruction

“…Usually, in a severely traumatized nose, a cantilevered bone graft 3 is often essential to restore bony and cartilaginous support. The donor sites for the bone usually include the cranium, rib, and olecranon.…”

An updated diced cartilage fascia technique for dorsal augmentation in rhinoplasty

“…Early attempts were decidedly crude, with a wide assortment of everyday materials including ivory [1] and jade used to increase the height of the nose. Through the years surgeons have attempted to improve outcomes by utilizing a variety of autologous and alloplastic materials, including: cartilage, bone [2][3][4] , fascia [5] diced cartilage and fascia [6][7][8][9] , silicone [10][11][12] , medpore [13] , polytetrafluorethylene [14,15] , supramid [16] , proplast [17] , vicryl [18] , and mersilene [19] . All with mixed results.…”

“…While many contemporary surgeons favor autologous grafts in an onlay configuration for mild to moderate amounts of dorsal augmentations [2,10,20] , cases demanding a larger volume of graft materials have prompted surgeons to explore alloplastic (silicone, Goretex, etc.) and homoplastic (irradiated costal cartilage) options in addition to autologous options given the ease of obtaining grafts, and the absence of any donor site morbidity [2][3][4][5] . However, a primary downside of these grafts has proven to be the relatively high risk of complications compared to autologous graft techniques, driving other surgeons to pursue this avenue more intently.…”