Failed septal extension graft in a patient with a history of radiotherapy.
BACKGROUND
This report describes the authors' experience of "melting" septal cartilage after placement of a septal extension graft in a nasopharyngeal cancer patient that had been previously undergone radiation therapy, and provides a review of the literature.


METHODS
Electronic medical records were used to obtain details of the patient's clinical history.


RESULTS
A 32-year-old woman, who had previously undergone radiotherapy for nasopharyngeal cancer, visited our department to for rhinoplasty. Rhinoplasty was performed using a septal extension graft to raise the nasal tip (first operation). Five days after surgery, it was found that the septal extension graft was melting without any signs of infection, that is, the graft had softened, lost elasticity, thinned, and partially disappeared without any sign of infection at 5 days, and thus, the nasal tip was reconstructed with conchal cartilage (second operation). Five months after surgery, it was found that almost all septal cartilage had disappeared without any sign of infection, and thus, the entire nasal septum was reconstructed using 2-mm costal cartilage and an onlay graft was used for tip augmentation (third operation).


CONCLUSIONS
After cartilage has been exposed to radiotherapy, its patency should be viewed with suspicion. Further studies are needed for determine the mechanism responsible for cartilage damage after radiotherapy.
Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Gachon University of Medicine and Science, Gil Medical Center, Guwoldong 1198, NamdongGu, Incheon City, 405-760 Korea.
Il Gyu
IG
Kang
Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Gachon University of Medicine and Science, Gil Medical Center, Guwoldong 1198, NamdongGu, Incheon City, 405-760 Korea.
Seon Tae
ST
Kim
Department of Radiation Oncology, Graduate School of Medicine, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Korea.
Seok Ho
SH
Lee
Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Gachon University of Medicine and Science, Gil Medical Center, Guwoldong 1198, NamdongGu, Incheon City, 405-760 Korea.
Min Kwan
MK
Baek
Nasal cartilages; Nasal septum; Radiotherapy; Rhinoplasty