title: Comparison of different autografts for aural cartilage in aesthetic rhinoplasty: is the tragal cartilage graft a viable alternative?
abstract: Auricular cartilage is an important source of grafts for various reconstructive procedures such as aesthetic rhinoplasty. The purpose of this investigation was to compare tragal cartilage with auricular cartilage harvested from the concha and scapha, and describe its clinical viability, indications, and morbidity in rhinoplasty. A total of 150 augmentation rhinoplasties with a total of 170 grafts were included. The donor sites were tragus (n=136), concha (n=26), and scapha (n=8). The time needed to harvest the grafts, the donor site morbidity, and the indications for operation were recorded. The anthropometric changes to 4 auricular variables after the cartilage had been harvested were analysed and compared with those on the opposite side in 48 patients using Student's paired t-test. Intraobserver reliability was assessed using Pearson's intraclass correlation. The mean (SD) harvesting time was 27 (8) min for the concha, 4.5 (1.4) min for the tragus, and 5.7 (1.6) min for the scapha. The largest graft was taken from the concha (28×19 mm), followed by the tragus (20×12 mm), and the scapha (18×6 mm). The grafts were placed at the following sites: tip grafts (n=123), columella struts (n=80), shield (n=20), rim (n=17), and dorsal onlay (n=15). Harvesting tragal cartilage is safe, simple, fast, and has a low morbidity, but it can affect the patient's ability to wear earphones. Tragal cartilage is a good alternative for nasal reconstruction if a graft of no longer than 20 mm is required.
authors.affiliation: Department of Oral and Craniomaxillofacial Surgery, University Cologne, Germany. Electronic address: drmaxzinser@yahoo.de.
authors.forename: Max J
authors.initials: MJ
authors.lastname: Zinser
authors.forename: Mathias
authors.initials: M
authors.lastname: Siessegger
authors.forename: Oliver
authors.initials: O
authors.lastname: Thamm
authors.forename: Panangiotis
authors.initials: P
authors.lastname: Theodorou
authors.forename: Mark
authors.initials: M
authors.lastname: Maegele
authors.forename: Lutz
authors.initials: L
authors.lastname: Ritter
authors.forename: Matthias
authors.initials: M
authors.lastname: Kreppel
authors.forename: Martin H
authors.initials: MH
authors.lastname: Sailer
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Zöller
authors.forename: Robert A
authors.initials: RA
authors.lastname: Mischkowski
mesh_terms: D000328:Adult; D064592:Autografts / Q000637:transplantation*; D002921:Cicatrix / Q000209:etiology; D004210:Dissection / Q000379:methods; D004425:Ear Cartilage / Q000033:anatomy & histology / Q000637:transplantation*; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods; D060053:Transplant Donor Site / Q000033:anatomy & histology
keywords: Concha; Grafts; Morbidity; Rhinoplasty; Scapha; Tragus