The caudal septum replacement graft.
OBJECTIVE
To describe a technique for reconstructing the lost tip support in cases involving caudal septal and premaxillary deficiencies.


METHODS
The study included 120 patients with aesthetic and functional nasal problems resulting from the loss of caudal septal and premaxillary support. An external rhinoplasty approach was performed to reconstruct the lost support using a cartilaginous caudal septum replacement graft and premaxillary augmentation with Mersilene mesh.


RESULTS
The majority of cases (75%) involved revisions in patients who had previously undergone 1 or more nasal surgical procedures. A caudal septum replacement graft was combined with premaxillary augmentation in 93 patients (77.5%). The mean follow-up period was 3 years (range, 1-12 years). The technique succeeded in correcting the external nasal deformities in all patients and resulted in a significant improvement in breathing in 74 patients (86%) with preoperative nasal obstruction. There were no cases of infection, displacement, or extrusion.


CONCLUSIONS
The caudal septum replacement graft proved to be very effective in restoring the lost tip support in patients with caudal septal deficiency. Combining the graft with premaxillary augmentation using Mersilene mesh helped increase support and stability over long-term follow-up.
Foda
Hossam M T
HM
Division of Facial Plastic Surgery, Department of Otolaryngology, Alexandria Medical School, Alexandria, Egypt. hfoda@dataxprs.com.eg
D006801:Humans; D009300:Nasal Septum / Q000601:surgery*; D012225:Rhinoplasty; D012272:Ribs / Q000637:transplantation