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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
Rivista di Chirurgia Maxillo-Facciale
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2011 June;22(2):79-84
Autogenous cartilage grafts and rhinoplasty: a retrospective study
Fini G. 1, Terenzi V. 2, Buonaccorsi S. 2, Leonardi A. 2, Indrizzi E. 1, Pellacchia V. 2
1 Maxillo-Facial Surgery Department, II Faculty of Medicine, “La Sapienza” University of Rome, Rome, Italy
2 Unit of Maxillo-Facial Surgery, I Faculty of Medicine,, “La Sapienza” University of Rome, Rome, Italy
Aim. Most common situations requiring cartilage grafts in rhinoplasty are secondary rhinoplasty cases and important post-traumatic and congenital nasal deformity, but cartilage grafts can be used also to camouflage slight irregularities in the tip and dorsum.
Methods. From March 2003 to Dicember 2006, a total of 270 patients underwent rhinoplasty among them, 45% cases required cartilage graft augmentation. The donor grafts averaged 75% nasal cartilage and 10.2% conchal cartilage; rispect 1% of polyethylene porous and 0.5% of costal cartilage. Then a 10% itis been used eterologue cartilage consevative in merthiolato. The recipient sites averaged 39.5% in the tip, 63% in the dorsum and 18.5% in the columella. All interventations were executed by the same surgeon by a closed approach.
Results. Functional and esthetic result was considered satisfactory in all cases. In no cases resorption or infection of the grafts, or morbidity at the donor site have been observed. Autogenous cartilage grafting, obteined after rhinoplasty or from auricolar or septal harvesting, has demonstrated to be an optimal procedure to camouflage slight irregularities in the tip and dorsum of the nose.
Conclusion. Tip grafts result very helpful to support the tip: onlay grafts had resolved complications of malposition and of too much projection through skin. In the case of dorsal augmentation attention has to be paid to the thickness of the graft in the proximal third of the dorsum to avoid prominence through skin. Autogenous cartilage graft augmentation demonstrated to be safe also in case of rejection or infection of an alloplastic implant.