Nasal Cartilage Grafts: More than a Decade of Experience

Abstract

From 1985 to 1995, a total of 311 patients underwent nasoplasties. During this time period, the number of patients receiving grafts increased from 94 percent in 1985-1989 to 100 percent in 1993-1995. The donor grafts averaged 72 percent nasal cartilage, 10 percent conchal cartilage, 9 percent fascia, and 9 percent rib allograft. Graft recipient sites averaged 41 percent in the tip, 31 percent in the dorsum, 17 percent in the columella, and 3 percent in the region of the lower lateral cartilage; 8 percent were spreader grafts. During this time frame, tip grafting increased from 34 percent in 1985-1989 to 54 percent in 1993-1995. Reoperation for complications decreased from 17 percent in 1985-1989 to 2 percent in 1993-1995. During the time span examined, the use of rib allografts declined, the use of autologous cartilage increased, the use of onlay tip grafts increased, and the incidence of reoperations declined. Early in the series, 80 percent of the malplaced tips were shield type grafts. With the use of the onlay tip graft, the complication of a malpositioned tip has been substantially diminished. The increased use of crushed cartilage has resulted in improvement in results and patient satisfaction, as it serves to camouflage slight irregularities in the tip and dorsum of the nose.

Salvage of Infected Cartilage Grafts for Nasal Reconstruction With a Through-and-Through Irrigation System

“…The incidence of infections associated with cartilage and bone graft use in nasal surgery averages 1% to 5%, occurring with increased frequency in major nasal reconstructions, multiple prior surgeries, scarring, or radiation as compared with primary rhinoplasty. [12][13][14][15][16][17][18][19] There does not appear to be any substantive difference in the infection rates associated with the use of autologous ear, costal rib, nasal septal, crushed cartilage grafts, or cryopreserved cartilage allografts in nasal surgery. [12][13][14][15][16][17]19 However, the composition and structure of sutures used in the fixation of cartilage grafts may well influence infection rates, especially in the presence of contamination or violation of the nasal cavity.…”

Comparison of Autogenous Cartilage, Acellular Dermis, and Solvent-Dehydrated Pericardium for the Prevention and Correction of Dorsal Nasal Irregularities: An Experimental Study

“…The nourishment of cartilage is a result of diffusion and the surrounding fibrous matrix [35,36]. They can easily be manipulated and the graft's elasticity and memory help to obtain firm support and stable contour.…”

Experimental comparative study in rabbits of three different ways of cartilage graft fixation: suture, gelatin-resorcin-formaldehyde and butyl-2-cyanoacrylate

“…The need for a graft when used for refinement should be assessed carefully, as the procedure has inherent complications. Autologous cartilage is the material most used for grafting, since it presents low reabsorption, infection, and extrusion degree [1]. However, one of the main complications associated with its use is displacement, and intranasal fixation is technically difficult [2].…”