Nasal reconstruction with articulated irradiated rib cartilage.
Nasal structural reconstruction is a formidable task in cases where there is loss of support to both the nasal dorsum and tip. A multitude of surgical approaches and materials have been used for the correction of the saddle-nose deformity with varying degrees of success. Articulated irradiated rib cartilage inserted through an external rhinoplasty approach was used to reconstruct nasal deformities in 18 patients over a 6-year period. Simultaneous use of a midline forehead flap to reconstruct the overlying soft tissue was required in four cases. Follow-up ranged from 1 to 6 years (mean, 2.8 years). Results were rewarding in most cases with marked improvement in nasal support and airway. Revision and/or replacement secondary to trauma or warping of the graft was required in four cases. None of the patients exhibited infection, extrusion, or noticeable resorption. A description of the surgical technique, review of all the cases, and recommendation for continued use of this graft material are discussed.
Murakami
C S
CS
Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle.
Cook
T A
TA
Guida
R A
RA
D000293:Adolescent; D000328:Adult; D002356:Cartilage / Q000528:radiation effects / Q000637:transplantation*; D006801:Humans; D008875:Middle Aged; D009667:Nose Deformities, Acquired / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology; D012086:Reoperation; D012225:Rhinoplasty / Q000379:methods*; D012272:Ribs