The Oblique Split Method

Taştan, Eren; Yücel, Ömer Taşkın; Aydın, Esra; Aydoğan, Filiz; Beriat, Kaan; Ulusoy, Mustafa Gürhan

doi:10.1001/jamafacial.2013.671

Cited by 56 publications

(18 citation statements)

References 11 publications

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“…These studies comprised 1041 patients of whom 741 received autologous grafts and 293 received IHCC grafts. Studies were published between January 1, 1990, and December 31, 2017; the mean sample size was 36 patients (range, 9-157 patients); and studies were from countries around the world, including Turkey (n = 9), 3,[23][24][25][26][27][28][29][30] the United States (n = 5), 9,13,[31][32][33] South Korea (n = 4), 14,18,19,34 Italy (n = 2), 35,36 India (n = 2), 37,38 the United Kingdom (n = 1), 39 Germany (n = 1), 40 the Netherlands (n = 1), 15 Egypt (n = 1), 41 South Africa (n = 1), 42 and Saudi Arabia (n = 1). 43 Mean follow-up time ranged from 6 to 48 months in the studies that reported follow-up, although 8 studies did not.…”

Section: Resultsmentioning

confidence: 99%

“…However, the use of costal cartilage has risks. The risk of warping is often discussed, [3][4][5][6][7][8] which has spurred various maneuvers to mitigate this risk, including carving techniques, suture techniques, microplate fixation, and Kirschner wires. In addition, the added morbidity associated with harvesting costal cartilage, including potential pneumothorax, scarring, and postoperative pain, as well as the added operative time raise the question of whether homologous costal cartilage can provide a similar result without harvesting autologous cartilage.…”

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confidence: 99%

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Comparison of Autologous vs Homologous Costal Cartilage Grafts in Dorsal Augmentation Rhinoplasty

Vila

Jeanpierre

Rizzi

et al. 2020

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Augmentation rhinoplasty requires adding cartilage to provide enhanced support to the structure of the nose. Autologous costal cartilage and irradiated homologous costal cartilage (IHCC) are well-accepted rhinoplasty options. Tutoplast is another alternative cartilage source. No studies, to our knowledge, have definitively demonstrated a higher rate of complications with IHCC grafts compared with autologous costal cartilage grafts. OBJECTIVE To compare rates of outcomes in the published literature for patients undergoing septorhinoplasty with autologous costal cartilage vs IHCC grafts vs Tutoplast grafts.DATA SOURCES For this systematic review and meta-analysis, the MEDLINE, Embase, Scopus, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched for articles published from database inception to February 2019 using the following keywords: septorhinoplasty, rhinoplasty, autologous costal cartilage graft, cadaveric cartilage graft, and rib graft.STUDY SELECTION Abstracts and full texts were reviewed in duplicate, and disagreements were resolved by consensus. Only patients who underwent an en bloc dorsal onlay graft were included for comparison to ensure a homogenous study sample. A total of 1308 results were found. After duplicate records were removed, 576 unique citations remained. Studies were published worldwide between January 1, 1990, and December 31, 2017.DATA EXTRACTION AND SYNTHESIS Independent extraction by 2 authors was performed. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURESAll reported outcomes after septorhinoplasty and rates of graft warping, resorption, infection, contour irregularity, and revision surgery among patients receiving autologous grafts vs IHCC vs Tutoplast cartilage grafts. RESULTSOf 576 unique citations, 54 studies were included in our systematic review; 28 studies were included after applying inclusion and exclusion criteria. Our search captured 1041 patients of whom 741 received autologous grafts and 293 received IHCC grafts (regardless of type). When autologous cartilage (n = 748) vs IHCC (n = 153) vs Tutoplast cartilage (n = 140) grafts were compared, no difference in warping (5%; 95% CI, 3%-9%), resorption (2%; 95% CI, 0%-2%), contour irregularity (1%; 95% CI, 0%-3%), infection (2%; 95% CI, 0%-4%), or revision surgery (5%; 95% CI, 2%-9%) was found. CONCLUSIONS AND RELEVANCENo difference was found in outcomes between autologous and homologous costal cartilage grafts, including rates of warping, resorption, infection, contour irregularity, or revisions, in patients undergoing dorsal augmentation rhinoplasty. En bloc dorsal onlay grafts are commonly used in augmentation rhinoplasty to provide contour and structure to the nasal dorsum.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Comparison of Autologous vs Homologous Costal Cartilage Grafts in Dorsal Augmentation Rhinoplasty

Vila

Jeanpierre

Rizzi

et al. 2020

JAMA Otolaryngol Head Neck Surg

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“…Centrally, carved grafts have been shown with a decreased rate of warping compared with peripherally carved grafts; but with the present methods, the risk of warping could not be totally eliminated. 5 A novel costal cartilage carving technique called “oblique split method (OSM),” introduced by Tastan et al in 2013 to remove warping by dividing the graft obliquely could provide equal circumferential forces of contracture. 5 The OSM provides a complete rib segment with an intact surface layer that can be easily carved.…”

Section: Introductionmentioning

confidence: 99%

“…5 A novel costal cartilage carving technique called “oblique split method (OSM),” introduced by Tastan et al in 2013 to remove warping by dividing the graft obliquely could provide equal circumferential forces of contracture. 5 The OSM provides a complete rib segment with an intact surface layer that can be easily carved. The flat surface of OSM graft is the cross section of the rib in which the diametrically opposed forces at all points are equal and may be said to be balanced.…”

Section: Introductionmentioning

confidence: 99%

Oblique Split Rib Graft Surgery in Primary and Secondary Septorhinoplasty

Loghmani

Maraki

2019

wjps

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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.

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“…[ 2 ] When costal cartilage graft is being used to make various struts (particularly the dorsal strut), the sharp edges need to be rounded off to decrease the chances of visibility of the graft underneath the thin dorsal nasal skin. [ 3 4 ] The inferior surface of the graft also needs to be straight to conform to the surface on which it rests.…”

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confidence: 99%