The hydroxyapatite Turkish Delight: a technical note

Abstract

Nasal dorsum augmentation is commonly performed using autologous cartilage grafts, also in the Turkish Delight technique. The aim of this study was to describe a modification of the Turkish Delight technique for dorsal augmentation consisting of small hydroxyapatite-calcium carbonate granules (0.5–1 mm) that were wrapped in layers of oxidized cellulose and glued with 1–2-cm3 fibrin sealant and to compare its utility with that of other techniques. Clinically stable and satisfactory results were achieved in the four cases examined. Cone-beam computerized tomography (CBCT) imaging revealed that there was no degradation of the graft up to 2 years after surgery. The use of a modified Turkish Delight method using hydroxyapatite granules promises to be a valuable option for the correction of nasal dorsum deficiency.

The Silicone Turkish Delight for Dorsal Augmentation in Rhinoplasty

“…Kustermans and Mommaerts used small hydroxyapatite granules (ProOsteon) wrapped in Surgicel and glued with 1 to 2 cm 3 of fibrin sealant in 4 patients and followed them up for 4 months-2 years. 17 Cone beam computed tomography images revealed complete mineralization of the graft with no degradation of the graft for up to 2 years. The authors in their technique have substituted the diced autologous cartilage grafts as described in the original technique of Turkish Delight with diced silicone pieces (0.5-1.0 mm) mixed in 1 to 2 ml of patient's blood and wrapped in a monolayer of oxidized cellulose and have observed stable results in 27 patients over a follow-up period of 24 to 60 months (average 30 months).…”

“…However, the fragile structure of the mass necessitated developing a wide surgical access to the recipient bed. Kustermans and Mommaerts used small hydroxyapatite granules (ProOsteon) wrapped in Surgicel and glued with 1 to 2 cm 3 of fibrin sealant in 4 patients and followed them up for 4 months-2 years 17 . Cone beam computed tomography images revealed complete mineralization of the graft with no degradation of the graft for up to 2 years.…”

The current techniques in dorsal augmentation rhinoplasty: a comprehensive review

“…Using diced cartilage wrapped in oxidized cellulose and named the Turkish Delight technique, Erol described the use of diced cartilage and then wrapped in oxidized cellulose. This technique has been modified to extend its applicability to more complex cases and enhance long-term results [ 76 , 94 ]. After tissue resolution is complete, it is possible to see carved or crushed cartilage through the nasal skin.…”

“…The graft remained stable 2 years after surgery using cone-beam computerized tomography (CBCT). In the treatment of nasal dorsum deficiency, hydroxyapatite granules have the potential to provide a valuable alternative to Turkish Delight [ 94 ].…”