Chapter 10. Ear Cartilage Harvest
Indications: The ear provides a readily accessible source of cartilage for structural support in the nose. Conchal cartilage is useful for support of the lateral sidewalls and alar rims (Figure 10-1). It can also be used for spreader grafts when septal cartilage is not available. It is noticeably less stiff and therefore more malleable than either septal or costal cartilage; however, both of these may be thinned to the appropriate thickness and pliability. If increased rigidity is necessary, ear cartilage may be reinforced with PDS foil that can be sutured to the graft. Composite skin and cartilage grafts can be harvested from the helical root for reconstruction of full thickness defects of the alar rim. Gentle scoring of the convex surface can create a roll of the cartilage to mimic the natural contour of the alar rim.
Figure 10-1. Extent of conchal cartilage harvest.
Markings: Cartilage from the ear may be harvested from either an anterior or posterior approach with adequate camouflage of the incision. The posterior incision is marked as a curvilinear line over the middle of the posterior ear (Figure 10-2). The incision for an anterior approach is similarly placed at the superior margin of the conchal bowl below the antihelix. In harvesting cartilage from the conchal bowl, care must be taken to avoid destruction of the helical root as it merges with the conchal bowl (Figure 10-3
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