title: A long-term evaluation of 150 costochondral nasal grafts.
abstract: BACKGROUND
  This paper reviewed the outcome of cantilevered costochondral grafts used for dorsal nasal augmentation in the management of patients treated at the Australian Craniofacial Unit (ACFU), Adelaide over a 29-year period.
  
  
  METHODS
  All patients undergoing dorsal nasal augmentation with costochondral grafts as part of their craniofacial management between 1981 and 2009 were identified using the ACFU database, and their medical notes were reviewed.
  
  
  RESULTS
  107 patients (50 M, 57 F), with a mean age of 12.3 years (range: 2-62 years) and requiring a total of 150 costochondral grafts, were identified from the departmental database. Mean follow-up after nasal augmentation was 5.6 years (1 month-31.5 years). 46% of the patients were diagnosed with Binder syndrome/Chondrodysplasia punctata; other diagnoses included Tessier midline clefts, cleft lip and palate and frontonasal dysplasia. A dorsal midline incision (49%) was the commonest method of access, with 84% of patients having mini-screw fixation for graft stabilisation. Complications included screw palpability, infection, skin necrosis and graft fracture. The commonest reasons for a replacement graft were graft atrophy and fracture, infection and persistent deformity.
  
  
  CONCLUSIONS
  Cantilevered nasal costochondral grafting is an excellent technique for improving nasal contour and function in a wide variety of clinical situations.
authors.affiliation: Department of Plastic Surgery, Frenchay Hospital, Bristol, South Gloucestershire BS16 1LE, United Kingdom. Electronic address: shaheelchummun@gmail.com.
authors.forename: Shaheel
authors.initials: S
authors.lastname: Chummun
authors.forename: Neil R
authors.initials: NR
authors.lastname: McLean
authors.forename: P J
authors.initials: PJ
authors.lastname: Anderson
authors.forename: D J
authors.initials: DJ
authors.lastname: David
mesh_terms: D000293:Adolescent; D000328:Adult; D001284:Atrophy; D002356:Cartilage / Q000473:pathology* / Q000637:transplantation*; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery; D019465:Craniofacial Abnormalities / Q000601:surgery; D005145:Face / Q000002:abnormalities / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery; D019767:Maxillofacial Abnormalities / Q000601:surgery; D008875:Middle Aged; D009666:Nose / Q000002:abnormalities / Q000601:surgery; D012086:Reoperation; D012225:Rhinoplasty / Q000009:adverse effects; D012272:Ribs; D013997:Time Factors; D055815:Young Adult
keywords: Costochondral graft; Craniofacial deformities; Nasal reconstruction