Radial bone graft usage for nasal septal reconstruction

Çil, Yakup; Koçman, Atacan Emre; Yapici, Abdul Kerim; Öztürk, Serdar

doi:10.4103/0970-0358.81446

Cited by 5 publications

(7 citation statements)

References 24 publications

(28 reference statements)

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“…In addition, the triangular shape of the fibula cortex lends itself appropriately to the desired shape of the nasal dorsum versus the flat C-shaped rib graft, which may also bend over time. 8 Others have reported the use of the excess fibula as a bone graft in combination with a vascularized fibula flap. The reported cases involve either mandibular reconstruction where the authors combine a fibular flap and the excess fibula as a graft to achieve greater vertical height or simultaneous mandibular and maxillary reconstruction, where the free fibula is used for the mandible and the excess is used as a bone graft for the maxilla.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Use of Banked Fibula for Improved Nasal Reconstruction Following Free Fibula Midface Reconstruction

Bernstein,

Reeve,

Kutler

et al. 2024

Journal of Craniofacial Surgery

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Objective: Anterior maxillary deficiency caused by trauma or oncologic resection presents a complex reconstructive challenge. The authors present a technique for 2-stage midface reconstruction utilizing a vascularized free fibula flap for maxillary reconstruction, followed by nasal reconstruction at a second stage utilizing a banked fibula graft. Methods: This case series utilizes a 2-stage technique for midface reconstruction. In the first stage, a fibula-free flap was used to reconstruct the maxilla with the excess banked in the abdomen. In the second stage, this bone graft was used to restore the nasal dorsum. Results: Two patients were included in this series. Patient 1 was a 28-year-old man who presented after a remote gunshot wound to his face, resulting in complete loss of his anterior maxilla and nasal support with midface collapse. Patient 2 was a 65-year-old man who presented with squamous cell carcinoma of the hard palate with extension into the maxilla and nasal septum. In both cases, the flaps healed without complication, providing midface restoration. Placement of the banked fibula graft in a second stage resulted in restoration of dorsal nasal projection. Conclusion: The authors describe the use of “spare” fibula parts for nasal reconstruction after loss of the maxilla and cartilaginous septum. The use of the fibula bone as a graft to restore the nasal dorsum in a delayed manner allows for a better assessment of the esthetic needs after the massive swelling from the initial surgery has abated. Further, this approach eliminates the need for a second donor site for nasal reconstruction.

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Section: Discussionmentioning

confidence: 99%

“…Different bone graft sources have been described, including rib, radius, olecranon, and calvarium, each with its own limitations. 2,[6][7][8] . However, in the cases presented here, the fibula was the obvious choice given its availability, thus obviating a second donor site.…”

Section: Discussionmentioning

confidence: 99%

Use of Banked Fibula for Improved Nasal Reconstruction Following Free Fibula Midface Reconstruction

Bernstein,

Reeve,

Kutler

et al. 2024

Journal of Craniofacial Surgery

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“…Different bone graft sources were described for nasal reconstruction. 7 - 9 Fibula is a longitudinal bone as radius, 8 and it is not curved as olecranon 9 and calvarial bone. 10 Lateral aspect of fibula provides a source of straight framework when shaped properly.…”

Section: Discussionmentioning

confidence: 99%

Radial bone graft usage for nasal septal reconstruction

Çil

Koçman

Yapici

et al. 2011

Indian J Plast Surg

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Background: Although various techniques have been described for correction of crooked and saddle nose deformities, these problems are challenging with high recurrence and revision rates. Conventional septal surgery may not be adequate for nose reconstruction in crooked and saddle nose deformities. Materials and Methods: Between December 2005 and October 2009, six patients with crooked nose and five patients with saddle nose deformities underwent corrective surgery in our clinic. All patients were male, and the mean age was 21 years (range, 19-23 years). We used rigid radial bone graft to prevent redeviation and recurrence following corrective nasal septal surgery. Results: The mean follow-up period was 28 months, ranging from 18 to 46 months. Mean operation time was 4 hours (3-4.5). All patients healed uneventfully. None of the patients required secondary surgery. Conclusions: We believe that radial bone grafts offer a long lasting support in treatment of challenging cases with crooked and saddle nose deformities.

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“…In rhinoplasty, bone grafting was first performed in 1975 by Sheen [7]; this procedure reconstructed the nasal tip using bone from the nasal radix. Since then, various methods including transplantation of a rib graft into the alar collapse region [8], septum reconstruction with a radial bone [9], and spreader grafting with an ethmoid perpendicular plate [10] have been introduced and are widely performed.…”

Section: Discussionmentioning

confidence: 99%