Complications Associated With the Use of Autologous Costal Cartilage in Rhinoplasty: A Systematic Review

Varadharajan, Kiran; Sethukumar, Priya; Anwar, Mohiemen; Patel, Kalpesh

doi:10.1093/asj/sju117

Cited by 88 publications

(85 citation statements)

References 21 publications

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“…To our knowledge, there are no studies reporting increased rates of infection in pediatric patients. This rate of infection is much less than that of nonabsorbable alloplastic implants used in adults and is similar to infection rates seen using autologous cartilage grafts in adults . This suggests that PDS is safe for use in septorhinoplasty and does not increase the rate of infection beyond that seen with autologous cartilage.…”

Section: Discussionsupporting

confidence: 56%

“…This rate of infection is much less than that of nonabsorbable alloplastic implants used in adults and is similar to infection rates seen using autologous cartilage grafts in adults. [1][2][3][5][6][7][8][9][10][11][12] This suggests that PDS is safe for use in septorhinoplasty and does not increase the rate of infection beyond that seen with autologous cartilage. However, closer inspection into the pediatric population is warranted.…”

Section: Discussionmentioning

confidence: 96%

“…Often, the septum can be straightened and supported using standard techniques such as spreader grafts, extended spreader grafts, or a swinging door. Autologous cartilage is typically the preferred grafting material as it is biocompatible, nonimmunogenic, and has a low risk of infection and extrusion . Septal, conchal, and costal cartilage are the most frequently used; however, the use of these autologous cartilage grafts may be limited by prior surgical resection, donor site morbidity, calcification, poor cartilage quality, septal fracture, or patient preference.…”

Section: Introductionmentioning

confidence: 99%

“…Autologous cartilage is typically the preferred grafting material as it is biocompatible, nonimmunogenic, and has a low risk of infection and extrusion. [1][2][3] Septal, conchal, and costal cartilage are the most frequently used; however, the use of these autologous cartilage grafts may be limited by prior surgical resection, donor site morbidity, calcification, poor cartilage quality, septal fracture, or patient preference. Additionally, bracing the L-strut fracture or deviation with autologous cartilage may result in a straight but widened septum, causing further narrowing of the nasal valves and persistent obstruction.…”

Section: Introductionmentioning

confidence: 99%

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Polydioxanone plates are safe and effective for L‐strut support in functional septorhinoplasty

2017

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Polydioxanone plates are safe and effective for L‐strut support in functional septorhinoplasty

2017

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“…There is a plentiful supply available, with a very low morbidity donor site. 2,3 It is easily carved and sculpted and has good dimensional stability in most cases, and the occasional tendency to warping can be counteracted. It has the intrinsic strength and rigidity to provide secure support for the nasal dorsum and tip, but also has a natural feel and a degree of mobility that mimics to an extent the natural flexibility of the cartilagi nous part of the nose.…”

Section: Ijhns Original Researchmentioning

confidence: 99%

Nasal Reconstruction with Carved Costal Cartilage Grafts

Richardson¹,

Laycock²,

Laraway³

et al. 2018

International Journal of Head and Neck Surgery

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Introduction: Complex reconstructive septorhinoplasty requires harvesting a large amount of tissue for grafting. Autogenous costochondral and auricular cartilage has generally considered the gold standard grafting material, if insufficient septal cartilage remains. The aim of this paper was to describe our technique and report our experience with the use of costal cartilage grafts in cases with significant nasal deformities with insufficient septal cartilage.Design: Retrospective review of patients who underwent septorhinoplasty with costochondral grafts between 1995 and 2015.

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Comparison of the Surgical Outcomes of Dorsal Augmentation Using Expanded Polytetrafluoroethylene or Autologous Costal Cartilage

Joo

Jang

2016

JAMA Facial Plast Surg

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IMPORTANCE Dorsal augmentation material includes alloplastic implants and autologous tissues. However, there has been no comparison to date of dorsal augmentation using different materials performed by the same surgeon. OBJECTIVE To compare the aesthetic outcomes and complications of dorsal augmentation using expanded polytetrafluoroethylene (ePTFE) and autologous costal cartilage (ACC) in rhinoplasty. DESIGN, SETTING, AND PARTICIPANTS A retrospective review of the medical records of 244 patients who underwent dorsal augmentation performed by the same surgeon at the Asan Medical Center using ePTFE or ACC from March 1, 2003, through September 31, 2015. MAIN OUTCOMES AND MEASURES Patient demographics and surgical procedures were analyzed. The aesthetic outcomes were scored from 1 (worst) to 4 (best) by 3 otolaryngologists. Changes in dorsal height and radix height were measured by comparing preoperative and postoperative profile views. Postoperative complications were also evaluated. RESULTS A total of 244 patients who underwent augmentation rhinoplasty were reviewed in this study, including 141 men (57.8%) and 103 women (42.2%). The ePTFE group included 176 patients, and the ACC group comprised 68 patients. In the ePTFE and ACC groups, 96 patients (54.5%) and 45 patients (66.2%) were male, respectively. The patient ages ranged from 11 to 69 years, with a mean (SD) age of 30.3 (11.49) years in the ePTFE group and 36.04 (12.65) years in the ACC group. The mean (SD) aesthetic outcome scores were comparable between the 2 groups: 2.99 (0.05) in the ePTFE group and 2.99 (0.06) in the ACC group (P = .93). The change of dorsal (2.64% in ePTFE group and 5.82% in ACC group) and radix (3.62% in ePTFE group and 3.77% in ACC group) heights were significantly increased after augmentation in both groups (P < .001) even though the dorsal height of the ACC group after augmentation showed a significantly greater increase compared to the ePTFE group (P < .001). However, the complication rate was significantly higher in the ACC group: 4.0% in ePTFE group and 11.8% in ACC group (P = .02). CONCLUSIONS AND RELEVANCE Dorsal augmentation with ACC produces similar aesthetic outcomes but a higher complication rate than dorsal augmentation with ePTFE. This higher complication rate may justify the use of ePTFE implants for dorsal augmentation in Asian patients undergoing rhinoplasty. LEVEL OF EVIDENCE 3.

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Complications Associated With the Use of Autologous Costal Cartilage in Rhinoplasty: A Systematic Review

Abstract: 4 Therapeutic.

Cited by 88 publications

References 21 publications

Polydioxanone plates are safe and effective for L‐strut support in functional septorhinoplasty

Polydioxanone plates are safe and effective for L‐strut support in functional septorhinoplasty

Nasal Reconstruction with Carved Costal Cartilage Grafts

Comparison of the Surgical Outcomes of Dorsal Augmentation Using Expanded Polytetrafluoroethylene or Autologous Costal Cartilage

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