Economizing the Septal Cartilage for Grafts During Rhinoplasty, 40 Years' Experience.
Alar rim grafts
Columellar strut
Conchal cartilage
Onlay graft
Revision rhinoplasty
Rhinoplasty
Rib cartilage
Septal cartilage
Shield graft
Spreader graft
Journal
Aesthetic plastic surgery
ISSN: 1432-5241
Titre abrégé: Aesthetic Plast Surg
Pays: United States
ID NLM: 7701756
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
11
06
2020
accepted:
21
07
2020
pubmed:
9
8
2020
medline:
26
2
2021
entrez:
9
8
2020
Statut:
ppublish
Résumé
During rhinoplasty, it is typically necessary to use cartilage to shape and support the final nasal construct to provide both form and function to the nose (Tanna et al. in Plast Reconstr Surg 141(1):137e-151e, 2018; Guyuron in Plast Reconstr Surg 105(6):2257-2259, 2000; Kim et al. in Ann Plast Surg 65(6):519-523, 2010). The septal cartilage is the ideal graft both for its ease of access and quality of cartilage. However, this graft is a limited resource, and economy of its use is important as to negate the need to harvest cartilage from the ear or rib. 1. To share the senior author's 40 years' experience with the economy of septal cartilage. 2. To identify the areas of the septal cartilage most suitable for a particular graft. 3. To discuss the common grafts that are used in rhinoplasty. 4. To identify when other sources of cartilage are needed and where to best use those grafts. 5. To present option for preservation of the leftover septal cartilage. Overall consideration should focus on the size, thickness, and curvature of the graft contemplating the structural and functional needs of the rhinoplasty maneuvers. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Sections du résumé
BACKGROUND
During rhinoplasty, it is typically necessary to use cartilage to shape and support the final nasal construct to provide both form and function to the nose (Tanna et al. in Plast Reconstr Surg 141(1):137e-151e, 2018; Guyuron in Plast Reconstr Surg 105(6):2257-2259, 2000; Kim et al. in Ann Plast Surg 65(6):519-523, 2010). The septal cartilage is the ideal graft both for its ease of access and quality of cartilage. However, this graft is a limited resource, and economy of its use is important as to negate the need to harvest cartilage from the ear or rib.
THE PURPOSE
1. To share the senior author's 40 years' experience with the economy of septal cartilage. 2. To identify the areas of the septal cartilage most suitable for a particular graft. 3. To discuss the common grafts that are used in rhinoplasty. 4. To identify when other sources of cartilage are needed and where to best use those grafts. 5. To present option for preservation of the leftover septal cartilage.
CONCLUSION
Overall consideration should focus on the size, thickness, and curvature of the graft contemplating the structural and functional needs of the rhinoplasty maneuvers.
LEVEL OF EVIDENCE V
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Identifiants
pubmed: 32766918
doi: 10.1007/s00266-020-01894-w
pii: 10.1007/s00266-020-01894-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
224-228Références
Tanna N et al (2018) Evidence-based medicine: current practices in rhinoplasty. Plast Reconstr Surg 141(1):137e–151e
doi: 10.1097/PRS.0000000000003977
Guyuron B (2000) Dynamics in rhinoplasty. Plast Reconstr Surg 105(6):2257–2259
doi: 10.1097/00006534-200005000-00057
Kim JS et al (2010) Intraoperative measurements of harvestable septal cartilage in rhinoplasty. Ann Plast Surg 65(6):519–523
doi: 10.1097/SAP.0b013e3181d59f95
Miles BA et al (2007) Anatomical variation of the nasal septum: analysis of 57 cadaver specimens. Otolaryngol Head Neck Surg 136(3):362–368
doi: 10.1016/j.otohns.2006.11.047
Ponsky D, Eshraghi Y, Guyuron B (2010) The frequency of surgical maneuvers during open rhinoplasty. Plast Reconstr Surg 126(1):240–244
doi: 10.1097/PRS.0b013e3181dc54da
Guyuron B, Michelow BJ (1994) Management of intraoperative nasal septal tears and perforations. Aesthet Plast Surg 18(1):61–63
doi: 10.1007/BF00444249
Most SP, Rudy SF (2017) Septoplasty: basic and advanced techniques. Facial Plast Surg Clin North Am 25(2):161–169
doi: 10.1016/j.fsc.2016.12.002
Guyuron B, Behmand RA (2003) Caudal nasal deviation. Plast Reconstr Surg 111(7):2449–2457 discussion 2458-9
doi: 10.1097/01.PRS.0000060802.70218.FE
Mowlavi A et al (2006) Septal cartilage defined: implications for nasal dynamics and rhinoplasty. Plast Reconstr Surg 117(7):2171–2174
doi: 10.1097/01.prs.0000218182.73780.d2
Hwang K, Huan F, Kim DJ (2010) Mapping thickness of nasal septal cartilage. J Craniofac Surg 21(1):243–244
doi: 10.1097/SCS.0b013e3181c5a203
Stepnick D, Guyuron B (2010) Surgical treatment of the crooked nose. Clin Plast Surg 37(2):313–325
doi: 10.1016/j.cps.2009.12.001
Katira K, Guyuron B (2015) Contemporary techniques for effective nasal lengthening. Facial Plast Surg Clin North Am 23(1):81–91
doi: 10.1016/j.fsc.2014.09.006
Xia TY et al (2020) Updated dynamics of rhinoplasty: a review of the literature and comprehensive list of the findings. Aesthet Plast Surg 44:904–909
doi: 10.1007/s00266-020-01619-z
Guyuron, B (2000) Choice of tip augmentation techniques: operative techniques. Plast Reconstr Surg. 7(4):201–207,495–501.
Guyuron B (2008) MOC-PS(SM) CME article: late cleft lip nasal deformity. Plast Reconstr Surg 121(4 Suppl):1–11
pubmed: 18379385
Guyuron B, Ghavami A, Wishnek SM (2005) Components of the short nostril. Plast Reconstr Surg 116(5):1517–1524
doi: 10.1097/01.prs.0000182590.01431.3d
Guyuron B, Wang DZ, Kurlander DE (2018) The cartilage warp prevention suture. Aesthet Plast Surg 42(3):854–858
doi: 10.1007/s00266-017-1052-3
Arslan F, Yildiz CA (2018) A Practical Suggestion for prepare dorsal onlay graft. J Craniofac Surg 29(4):e344–e345
doi: 10.1097/SCS.0000000000004273
Guyuron B (1996) Dynamic interplays during rhinoplasty. Clin Plast Surg 23(2):223–231
doi: 10.1016/S0094-1298(20)31112-3
Guyuron B (1998) Nasal osteotomy and airway changes. Plast Reconstr Surg 102(3):856–860 discussion 861-3
doi: 10.1097/00006534-199809010-00037
Gerecci D, Perkins SW (2019) The use of spreader grafts or spreader flaps-or not-in hump reduction rhinoplasty. Facial Plast Surg 35(5):467–475
doi: 10.1055/s-0039-1695727
Guyuron B, Varghai A (2003) Lengthening the nose with a tongue-and-groove technique. Plast Reconstr Surg 111(4):1533–1539 discussion 1540-1
doi: 10.1097/01.PRS.0000049637.42449.80
Ponsky DC et al (2010) Nose elongation: a review and description of the septal extension tongue-and-groove technique. Aesthet Surg J 30(3):335–346
doi: 10.1177/1090820X10374103
Guyuron B (1991) Dynamics of rhinoplasty. Plast Reconstr Surg 88(6):970–978 discussion 979
doi: 10.1097/00006534-199112000-00004
Guyuron B, Jackowe D (2007) Modified tip grafts and tip punch devices. Plast Reconstr Surg 120(7):2004–2010
doi: 10.1097/01.prs.0000287329.13026.1f
Pi H, Kurlander DE, Guyuron B (2017) Effects of the rhinoplasty maneuvers on upper lip position and incisor show. Aesthet Plast Surg 41(1):135–139
doi: 10.1007/s00266-016-0760-4
Guyuron B (1986) Simplified harvesting of the ear cartilage graft. Aesthet Plast Surg 10(1):37–39
doi: 10.1007/BF01575266
Guyuron B (2001) Alar rim deformities. Plast Reconstr Surg 107(3):856–863
doi: 10.1097/00006534-200103000-00032
Guyuron B, Bigdeli Y, Sajjadian A (2015) Dynamics of the alar rim graft. Plast Reconstr Surg 135(4):981–986
doi: 10.1097/PRS.0000000000001128
Totonchi A, Guyuron B (2016) Alar rim deformities. Clin Plast Surg 43(1):127–134
doi: 10.1016/j.cps.2015.09.014
Ballin AC et al (2016) The articulated alar rim graft: reengineering the conventional alar rim graft for improved contour and support. Facial Plast Surg 32(4):384–397
doi: 10.1055/s-0036-1585573
Guyuron B, Lee M (2017) An effective algorithm for management of noses with thick skin. Aesthet Plast Surg 41(2):381–387
doi: 10.1007/s00266-017-0779-1
Gruber RP, Wall SH, Kaufman DL, Kahn DM (2018) Plastic surgery, vol 3. Elsevier Inc., pp 502–522
Guyuron B, Poggi JT, Michelow BJ (2004) The subdomal graft. Plast Reconstr Surg 113(3):1037–1040 discussion 1041-3
doi: 10.1097/01.PRS.0000105699.89793.44
Lee M, Guyuron B (2016) Dynamics of the subdomal graft. Plast Reconstr Surg 137(6):940e–e945
doi: 10.1097/PRS.0000000000002225
Whitaker EG, Johnson CM Jr (2003) The evolution of open structure rhinoplasty. Arch Facial Plast Surg 5(4):291–300
doi: 10.1001/archfaci.5.4.291
Guyuron B, Afrooz PN (2008) Correction of cocaine-related nasal defects. Plast Reconstr Surg 121(3):1015–1023
doi: 10.1097/01.prs.0000299464.02430.78
Guyuron B, Friedman A (1994) The role of preserved autogenous cartilage graft in septorhinoplasty. Ann Plast Surg 32(3):255–260
doi: 10.1097/00000637-199403000-00005
Rudderman RH, Guyuron B, Mendelsohn G (1994) The fate of fresh and preserved, noncrushed and crushed autogenous cartilage in the rabbit model. Ann Plast Surg 32(3):250–254
doi: 10.1097/00000637-199403000-00004