title: Healing of composite chondrocutaneous auricular grafts covered by skin flaps in nasal reconstructive surgery.
abstract: OBJECTIVE
  Healing of composite chondrocutaneous auricular grafts combined with overlying skin flaps for reconstruction of the internal lining in partial nasal defects should be evaluated.
  
  
  METHODS
  A retrospective chart review and prospective clinical follow-up of 15 patients with partial nasal defects.
  
  
  METHODS
  Fifteen patients with partial defects of the middle and lower third of the nose were reviewed. Nineteen composite ear grafts were used for reconstruction of the internal nasal lining in the patient group. The composite grafts were used in combination with overlying nasolabial transposition flaps. In some patients paramedian forehead or turn-in flaps were needed as well. Functional and aesthetic results of nasal reconstruction were subjectively graded by the patients and medical doctors of the department.
  
  
  RESULTS
  Three of 19 transplanted composite grafts showed postoperative deformation. Relative shrinkage was observed in 5 of 19 composite grafts, whereas complete loss of the composite graft was seen in only one patient. Nasal airway obstruction was observed in the patients with deformity or loss of composite graft (4 of 15 patients), and an unsuccessful aesthetic result was seen only in the patient with total composite graft failure (1 of 19 transplanted grafts).
  
  
  CONCLUSIONS
  Composite ear grafts may provide good functional and aesthetic results when combined with overlying skin flaps in reconstruction of partial nasal defects. Even though composite ear grafts used for restoration of the inner nasal lining may be deformed or absorbed and impairment of nasal airway patency or aesthetic result may be postoperatively observed, the combination of composite ear grafts with locoregional transposition flaps provides additional reconstructive options for selected nasal defects.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University Medical School Ulm, Ulm, Germany. tilman.keck@medizin.uni-ulm.de
authors.forename: Tilman
authors.initials: T
authors.lastname: Keck
authors.forename: Jörg
authors.initials: J
authors.lastname: Lindemann
authors.forename: Stephan
authors.initials: S
authors.lastname: Kühnemann
authors.forename: Otto
authors.initials: O
authors.lastname: Sigg
mesh_terms: D000328:Adult; D000368:Aged; D004425:Ear Cartilage / Q000637:transplantation; D004431:Ear, External; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000293:injuries; D009667:Nose Deformities, Acquired / Q000601:surgery; D009669:Nose Neoplasms / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods; D016038:Skin Transplantation; D013524:Surgical Flaps; D014945:Wound Healing