Oblique Split Rib Graft Surgery in Primary and Secondary Septorhinoplasty

Abstract

BACKGROUND Rib cartilage is an outstanding material in reconstructive septorhinoplasty, especially in revision surgery with a low rate of complications compared to other materials. In this study, the results of oblique splitting of rib grafts were evaluated in 25 patients operated for primary and secondary septorhinoplasty. METHODS The prospective case series were undertaken on 25 patients of saddle or crooked nose that referred to the senior author’s private office between January 2015 and November 2017. They had primary and secondary septorhinoplasty using autologous costal cartilage carved by the oblique split method (OSM). The postoperative follow-up period ranged from 3 to 36 months (Mean follow up of 19 months). RESULTS The problems seen in patients were saddle-nose deformity in 16 cases, crooked-nose deformity in 3, crooked nose and saddle nose in 3 and implant infection, inverted V-pinch, destruction of septum in 3 more cases. After oblique split rib grafts surgery and 3-36 month follow-up (an average of 19 months), the operative outcomes were successful and no severe resorption, infection, warping or displacement were observed related to graft and patients were also satisfied, and there was no complication of the donor-site. The patients did not have any post-operative complications and no complain of nasal distortion during follow up period. CONCLUSION OSM allowed obtaining large quantities of graft material without the risk of warping due to inclusion of both peripheral and central portions of the rib cartilage.

Secondary Rhinoplasty Using Autologous Rib Cartilage: A Review

“…The most frequently applied techniques were delaying grafting or immersing the graft in solution before shaping and insertion. Gunter has described the use of K-wires to stabilize the rib cartilage grafts, but complications like infection, pain, numbness of the anterior palatal mucosa and extrusion of the K-wire can happen [10,11]. The use of K-wires can prevent warping, especially in larger dorsal and columellar grafts [7].…”

The Use of Auricular Cartilage Grafts in Septorhinoplasty: A Dual-Centre Study of Donor Site Patient-Reported Outcome Measures

“…The use of autologous cartilage grafts to achieve satisfactory long-term functional and aesthetic results is a key aspect of contemporary septorhinoplasty [1][2][3]. Successful reconstruction of the nasal framework can be hindered when septal cartilage is insufficient or of poor structural integrity.…”

“…Several disadvantages of this approach have been postulated within the literature, including donor site pain, deformity and subsequent impairment in quality of life (QOL) [ 5 ]. Autologous costal cartilage is often cited as a preferable source owing to its abundance, stiffness and relative donor site cosmesis [ 3 ]. Optimal graft material remains unclear, with relative complication rates of several methods cited within the literature [ 6 , 7 ].…”

Evaluation of Lateral Crura Divergence Angle of Iranian Candidates for Primary Rhinoplasty

“…The rhinoplasty initially aimed to create an attractive, functional nose without any surgical stigmata. [1][2][3] Having a detailed knowledge about nasal anatomy and comprehensive analysis of the facial and nasal region is important for surgeons to achieve the excellent results in rhinoplasty. In addition, preoperative planning is important for plastic surgeons to prevent unpredictable results.…”