title: Analysis of the development of the nasal septum and measurement of the harvestable septal cartilage in koreans using three-dimensional facial bone computed tomography scanning.
abstract: BACKGROUND
  The septal cartilage is the most useful donor site for autologous cartilage graft material in rhinoplasty. For successful nasal surgery, it is necessary to understand the developmental process of the nasal septum and to predict the amount of harvestable septal cartilage before surgery.
  
  
  METHODS
  One hundred twenty-three Korean patients who underwent three-dimensional (3D) facial bone computed tomography (CT) were selected for evaluation of the midsagittal view of the nasal septum. Multiple parameters such as the area of each component of the nasal septum and the amount of harvestable septal cartilage were measured using Digimizer software.
  
  
  RESULTS
  The area of the total nasal septum showed rapid growth until the teenage years, but thereafter no significant change throughout the lifetime. However, the development of the septal cartilage showed a gradual decline due to ossification changes with aging after puberty in spite of a lack of change in the total septal area. The area of harvestable septal cartilage in young adults was 549.84±151.26 mm(2) and decreased thereafter with age.
  
  
  CONCLUSIONS
  A 3D facial bone CT scan can provide valuable information on the septal cartilage graft before rhinoplasty. Considering the developmental process of the septal cartilage identified in this study, septal surgery should not be performed until puberty due to the risk of nasal growth impairment. Furthermore, in elderly patients who show a decreased cartilage area due to ossification changes, septal cartilage harvesting should be performed carefully due to the risk of saddle nose deformity.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Bundang Jesaeng General Hospital, Seongnam, Korea.
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, Bundang Jesaeng General Hospital, Seongnam, Korea.
authors.forename: Dong Ju
authors.initials: DJ
authors.lastname: Jung
authors.affiliation: Department of Plastic and Reconstructive Surgery, Bundang Jesaeng General Hospital, Seongnam, Korea.
authors.forename: Hyo Seong
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, Bundang Jesaeng General Hospital, Seongnam, Korea.
authors.forename: Chang Hyun
authors.initials: CH
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, Bundang Jesaeng General Hospital, Seongnam, Korea.
authors.forename: Tae Yeon
authors.initials: TY
authors.lastname: Kim
keywords: Multidetector computed tomography; Nasal cartilage; Nasal septum