Dorsal augmentation rhinoplasty by diced cartilage graft
Author(s): Alaa Ibrahim Al-Jorani* and Hamid Ibrahim Al-Jorani
Abstract
Dorsal augmentation in rhinoplasty in competition by multiple methods with developing of high care of medicine standards, that obtained by rapidly developing therapies and technological advances. Surgeons, through many years, have tried to evolve the outcomes of dorsal augmentation, by using different types of alloplastic and autologous materials, which include cartilage, bone and diced cartilage. Many surgeons prefer the using of the grafts which is autologous in the orderliness of dorsal augmentations in mild to moderate amounts, for nasal dorsal augmentation, cartilage and bone are considered as autologous source which are employed for this procedure. A total number of the patients that participated in this study were 50 patients (36 female(72%) and 14 male (28%), age of patients ranged between (19-47 years) whom underwent rhinoplasty of primary, revision and the nasal dorsum with secondary deformities, by using diced cartilage grafts through the open surgical approach. A reconstructive and plastic surgeon led the surgical team for all rhino pasties that were done in this study. The surgical technique was open rhinoplasty for all cases that was included in this study. Cartilage was harvested from the septum, rib, or concha. The nasal septum deviation that associated with cases was corrected at the same time, when the nasal septal cartilage was used as donor site of harvested cartilage. The nasal septal cartilage was used as donor site for harvested cartilage in 39 patients, nasal septal and conchal cartilages were used in 7 patients, and costal cartilage only was used in 4 patients. Three months was the minimum period of follow up, while seventeen months was the average period of follow-up. The complications were experienced in three patients, which included visible graft bulging in the rhinion area that was noticed in these patients. No graft resorption was noticed or observed in any of these three patients, patients were followed –up by serial photography, serial physical examination, and input was received from the patients. Augmentation rhinoplasty that use autogenous diced cartilage has good advantage result from malleability and easy insertion of this type of graft. Good results obtained from use the diced cartilage without wrapping of it in other material like Surgical or fascia with less or not complications such as cartilage resorption or warping.