Nasal septal abscess in children: reconstruction with autologous cartilage grafts on polydioxanone plate.
OBJECTIVE
To assess outgrowth and aesthetics of the nose in children after reconstruction of the cartilaginous nasal septum with autologous cartilage grafts on polydioxanone plate.


METHODS
Prospective nonrandomized case series.


METHODS
University hospital.


METHODS
Six patients (5 boys and 1 girl), aged 3 to 11 years, with nasal septal abscess.


METHODS
The nasal septa of 6 children with a history of nasal septal abscess and partial or complete destruction of nasal septal cartilage were reconstructed with autologous cartilage grafts of the auricle or rib fixed on polydioxanone plate.


METHODS
Nasal outgrowth was measured by the length of the nose and by the amount of nasal tip projection and was compared with standardized growth curves. Aesthetic outcome variables included nasolabial angle, columellar retraction, and development of saddle nose deformity and were classified as normal, mild, or severe.


RESULTS
The duration of follow-up ranged from 10 to 68 months (mean follow-up, 38 months). Four children had complete loss of the cartilaginous septum. Areas 1 and 2 (caudal parts) had been destroyed in 2 children. Auricular cartilage was used in 5 children; costal cartilage was needed in 1 child. Compared with standardized growth curves, the length of the nose and the amount of nasal tip projection were within 1 SD in all children. None of the children developed saddle nose deformity. One child had mild columellar retraction; 3 children had mild overrotation of the nasal tip.


CONCLUSIONS
Total reconstruction of abscess-induced destruction of nasal septal cartilage with autologous cartilage grafts fixed on polydioxanone plate has, so far, resulted in normal development of the nose during follow-up, without expected aesthetic problems.
Menger
Dirk J
DJ
Center for Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. D.J.Menger@amc.uva.nl
Tabink
Ivar C
IC
Trenité
Gilbert J Nolst
GJ
D000038:Abscess / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002356:Cartilage / Q000637:transplantation*; D002648:Child; D002675:Child, Preschool; D004322:Drainage; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008445:Maxillofacial Development / Q000502:physiology; D009300:Nasal Septum / Q000601:surgery*; D009667:Nose Deformities, Acquired / Q000175:diagnosis; D016687:Polydioxanone; D011183:Postoperative Complications / Q000175:diagnosis; D011446:Prospective Studies; D019736:Prostheses and Implants; D012086:Reoperation; D012225:Rhinoplasty / Q000379:methods*
D000900:Anti-Bacterial Agents; D016687:Polydioxanone