Reconstruction of Saddle Nose Deformity With Three-Dimensional Costal Cartilage Graft

Abstract

Saddle nose deformity is characterized by depression of the nasal bone and the cartilage dorsum associated with a collapse in the upper lateral and alar cartilages. Etiopathogenesis usually involves trauma or invasive excision of the bone and cartilage. Surgical treatment for functional and aesthetic recovery relies on the use of grafts. Options for grafting include autogenous tissue such as bone or cartilage and alloplastic augmentation. Nine patients with saddle nose deformity underwent surgical reconstruction with autogenous costal cartilage. The deformity was the result of trauma in seven patients and secondary to surgery in two patients. Cartilage obtained from the sixth and seventh ribs was used as the graft material to compensate for the low nasal dorsum. Cartilage was used as a single unit and shaped to cover the nasal dorsum and the lateral nasal walls completely. The upper lateral cartilages were fixed to shaped cartilage graft. Additional cartilage grafts into the columella and septum were also placed in all patients. Functional and aesthetic outcome was satisfactory in all patients. As a result, using costal cartilage graft, a single unit allowed more predictable and reliable reconstruction of the saddle nose deformity than the conventional dorsal grafts.

Cell bricks-enriched platelet-rich plasma gel for injectable cartilage engineering - an in vivo experiment in nude mice

“…Matrix‐induced autologous chondrocyte implantation (MACI) has been reported in clinical articular cartilage reconstruction (Ebert et al ., ; Harris et al ., ). Encouraging results have been reported in reconstructing the nose, ear and trachea using tissue‐engineering techniques (Bilen and Kilinc, ; Macchiarini et al ., ; Park, ). The scaffold, which acts as a cell carrier, not only plays important role in maintaining cells in defect sites and shaping tissue formation but is also expected to delivery biological cues to residing cells, thus facilitating chondrogenesis (Bekkers et al ., ; Frisbie et al ., ; Raghunath et al ., ).…”

Reconstructive Rhinoplasty Using Multiplanar Carved Costal Cartilage

“…It is widely reported that rib grafts provide necessary autologous cartilage. [2][3][4][5][6][7][8][9] Use of costal cartilage includes carving traditional rhinoplasty grafts, such as dorsal onlay, spreader, or septal extension grafts. [3][4][5][6]8,9 The possibility of warping is the major deterrent to the use of costal cartilage 4,9,10 despite low rates of infection or extrusion.…”

Reconstruction of significant saddle nose deformity using autogenous costal cartilage graft with incorporated mirror image spreader grafts

“…Reconstruction of a major saddle nose deformity requires structural replacement—a common indication for rib grafting. This involves reconstruction of dorsal and caudal support structure with two articulated pieces of rib8 or a single unit costal cartilage graft 9. Alternatively, the rib graft can be used to create a stable midline septum 10.…”