Modified back-to-back autogenous conchal cartilage graft for caudal septal reconstruction: the medial crural extension graft.
OBJECTIVE
To report our experience with the use of a modification of the back-to-back autogenous conchal cartilage graft, used as a medial crural extension graft, for reconstruction of the caudal septum.


METHODS
Retrospective review of all patients undergoing caudal septal reconstruction using a modification of the back-to-back conchal cartilage graft from January 1, 2007, through June 1, 2009, at a tertiary referral center. Photodocumentation of all patients was obtained preoperatively and postoperatively. Patients were asked to subjectively rate their functional and cosmetic outcomes at each follow-up visit.


RESULTS
Eight patients underwent caudal septal reconstruction with the modified back-to-back conchal cartilage graft during the time period studied. Six patients underwent caudal septal reconstruction via external septorhinoplasty while 2 patients underwent an endonasal approach. The median duration of follow-up was 12 months. At the last follow-up, patients rated their breathing as normal in 7 of 8 cases and improved, but not to normal, in 1 of 8 cases. Cosmesis was rated as excellent in 7 of 8 cases and good in 1 of 8 cases. There were no postoperative complications.


CONCLUSIONS
Modification of the back-to-back autogenous conchal cartilage graft used as a medical crural extension graft should be considered for reconstruction of the caudal septum in the cartilage deficient nose. The technique produces reliable outcomes with minimal donor site morbidity.
Department of Otorhinolaryngology–Head and Neck Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Cody A
CA
Koch
Oren
O
Friedman
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004425:Ear Cartilage / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055171:Nasal Cartilages / Q000601:surgery; D009300:Nasal Septum / Q000601:surgery*; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome