Management of the Keel Nose and Associated Valve Collapse

Abstract

Conchal cartilage overlay repair uses a cartilage graft from the auricle with a recommended external rhinoplasty for placement. Appropriate sizing and fashioning precede the precise placement and suture fixation. This technique addresses both functional and cosmetic abnormalities.

The Conchal Cartilage Butterfly Graft

“…They must also be aware of the possible visibility of the conchal cartilage graft as a horizontal line across the supratip once healing is complete. In most circumstances, however, in the properly selected patient and with increased surgical experience, excellent cosmetic outcomes may be achieved with the conchal cartilage butterfly graft in both primary and revision rhinoplasty [3][4][5]7,10,16,18,20 (►Fig. 11a, b).…”

Surgical techniques for the treatment of nasal valve collapse

“…Of the study group, 19% were unhappy with the cosmetic outcome, specifically an excessively broad middle nose vault. Stucker8, 53 used conchal cartilage as a simple onlay graft over the ULC with good result. No studies comparing these similar grafts have been published.…”

Prevention and Correction of Airway Compromise in Rhinoplasty

“…Preservation of at least 5 mm of intact rim when trimming the lower lateral cartilages provides for adequate inspiratory support at the level of the external valve. 1,6 If the lower lateral cartilage is damaged, malpositioned, or structurally inadequate (case 2), septal or conchal grafts can be used as a bolster to achieve the desired contour and provide airway support. If the caudal septum and/or footplates of the lower lateral cartilages are damaged, structurally weak, or absent because of resection or trauma (case 3), a columellar strut graft can provide both structural airway support and tip support.…”