Use of Irradiated Cartilage in Rhinoplasty of the

Authors: Strauch Berish Erhard Heather A Baum Thomas

Publish Date: 2004/07/01

Volume: 24, Issue: 4, Pages: 324-330

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Abstract

Methods Individually packaged specimens of IHCC were obtained from governmentapproved tissue banks for intraoperative use in the augmentation of the dorsum as an onlay graft and when necessary to create maxillarycolumellartip MCT struts and crural and spreader grafts A Vshaped cut was made at the base of the MCT graft to accommodate the anterior maxillary ridge The dorsalonly cartilage grafts were sutured to the underlying periosteum and framework to prevent tipping or shifting of the cartilage Small tip grafts were not used and defatting of the tip skin was avoidedResults Patients were monitored for periods ranging from 7 months to 14 years No immediate complications were noted and only 1 late complication ⋙30 days after surgery occurred it involved the shifting of a dorsal graft that had not been sutured Patient satisfaction was excellentConclusions The use of IHCC for augmentation rhinoplasty of the nonCaucasian nose saves operative time eliminates both the need to harvest cartilage and the morbidity that can result from this procedure and provides excellent longlasting aesthetic results with few complicationsTo achieve patient satisfaction with the results of cosmetic rhinoplasty in nonCaucasian patients the surgeon must first understand the patients goals The intent should be to address a patients specific anatomic concerns and through surgery approach his or her concepts of normality and beauty for the patients ethnic group The goal should be to maintain characteristics in keeping with a patients ethnicity rather than try to create a more “Caucasian” noseMany materials are available for use as grafts in augmentation rhinoplasty including autografts of conchal septal or costal cartilage In nonCaucasian patients substantial grafts such as those found in rib cartilage are generally needed However adverse effects associated with the harvest of graft material from a patients rib include the resultant morbidity and increased operative time Although alloplastic materials have the advantage of being readily available displacement and infection continue to be a problem because of these materials lack of integration into the body Irradiated homograft costal cartilage IHCC in many ways is the ideal graft because it combines the benefits provided by autologous and alloplastic materials It is both biocompatible and adaptable allowing it to be carved and contoured to any length or thickness It eliminates the possibility of donorsite morbidity and is easily obtainable

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