Auricular Cartilage in Revision Rhinoplasty

Abstract

Revision rhinoplasty is a challenge in reconstruction to the rhinoplasty surgeon, both in the techniques of repair and the choice of implant material for augmentation grafting. Often, patients seeking revision or reconstructive rhinoplasty have previously undergone septoplasty with sacrifice of major amounts of septal cartilage. These situations confront the surgeon with the need for a decision about the material that will be used for structural grafting. The senior author follows the time-tested approach of generations of surgeons who have used exclusively autogenous material for nasal reconstruction because of its superior long-term survival characteristics, its ready availability in the head and neck region, its resistance to infection and resorption, and its bendability and flexibility when implanted in the nose. With this in mind, the subject of this article is the use of auricular cartilage in revision rhinoplasty. Careful strategic planning must be undertaken to get the maximal and ideal benefit from the auricular cartilage. The revision rhinoplasty surgeon must understand the anatomy of the external ear and must be able to manage the precious cartilage supply to get the maximum use of it in reconstructive rhinoplasty.

Nasal alar deformity: a very rare complication of acoustic neuroma surgery after ipsilateral trigeminal and facial nerve paralysis

“…However, a significant proportion of patients do not self-traumatize the anesthetic area of their face and therefore self-mani- incision was used for reconstruction as the skin was atrophic due to nerve dysfunction (19)(20)(21) .…”

Viability of crushed human auricular and costal cartilage chondrocytes in cell culture

“…In a clinical study, Endo et al (1991) used auricular cartilage layers as dorsal grafts and reported occasional graft resorption in 1263 patients that had been followed-up for a mean of 8 months. Although they did not mention the amount of resorption, Becker et al (2003) advocated the use of auricular cartilage in revision rhinoplasty, based on their clinical experience. Murrell (2004) has reviewed 101 patients in whom auricular cartilage grafts had been used and reported no graft resorption or extrusion after a follow up of up to 72 months.…”

An Overview of Nasal Dorsal Augmentation

“…13,21 Like septal cartilage, conchal grafts can be used as a single-layered implant or sutured together to increase girth and rigidity. 21,22 In the setting of a thin S-STE, including a portion of soft tissue on the posterior surface of the graft can provide some additional camouflage. 22 Even morselized, though, it occasionally causes palpable and visible dorsal irregularities, due to its intrinsic memory and possibility for resorption.…”

“…21,22 In the setting of a thin S-STE, including a portion of soft tissue on the posterior surface of the graft can provide some additional camouflage. 22 Even morselized, though, it occasionally causes palpable and visible dorsal irregularities, due to its intrinsic memory and possibility for resorption. 1 Additionally, conchal cartilage is more curved and less rigid than is septal cartilage; structure and support, therefore, are better achieved with septal or costal cartilage.…”