Aesthetic

Nose

Reconstruction of Significant Saddle Nose Deformity Using Autogenous Costal Cartilage Graft With Incorporated Mirror Image Spreader Grafts

Ahmed A, Imani P, Vuyk HD (Doncaster Royal Infirmary, UK; Tergooi Hosps, Blaricum, The Netherlands) Laryngoscope 120:491-494, 2010^§

Abstract

Background

Loss of septal height and tip support caused by deformities of the lower two thirds of the nose produces the classic “saddle nose” appearance. A few cases are congenital, but most result from previous septoplasty or rhinoplasty, facial trauma, or septal abscess. Cartilage filler grafts are sufficient to disguise minimal deformities and moderate ones with reasonable septal support are managed with dorsal onlay grafts plus a columellar strut and tip graft shaped from the patient’s remaining septal or conchal cartilage. For major deformities, significant structural restoration, often with homologous or autologous rib costal cartilage, is needed. Warping of the costal cartilage is a major complication of the process and can produce postoperative deformities. A technique to overcome the potential for warping was proposed.

Technique

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