The use of allogeneic cartilage for grafting in functional and reconstructive rhinoplasty

Publication date: Available online 27 March 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Andrew M. Read-Fuller, David M. Yates, Alaaaldin Radwan, Alexander M. Schrodt, Richard A. Finn
IntroductionAllogeneic cartilage grafting has multiple uses in rhinoplasty. Autogenous cartilage is frequently used in cases of nasal obstruction or reconstruction, but harvesting grafts can cause complications or may be contraindicated. Rhinoplasties on the cleft patient may require costochondral grafts. Allogeneic rib is an effective and safe alternative to autogenous grafts, prevents complications, and eliminates the need for postoperative admission after rib harvest.Materials and MethodsPatients who had allogeneic cartilage placed during functional or reconstructive rhinoplasty were studied from two institutions, including 19 who had functional rhinoplasty utilizing allogeneic Cartiform® patellar cartilage grafts, and 15 patients who underwent reconstructive cleft rhinoplasty with allogeneic rib cartilage. Postoperative follow up was for six months minimum, and graft handling characteristics and improvement in breathing were assessed. Internal/external nasal valve (INV/ENV) patency was evaluated in the Cartiform® patients, and cosmetic outcomes were rated in the reconstructive cleft patients.ResultsThe average age of the functional rhinoplasty patients was 57.57 years, and all were males with compromised nasal breathing. Cartiform® cartilage was used to repair INV or ENV collapse. Postoperatively, all patients had patent INVs and ENVs, and reported improved nasal breathing.The rib allograft patients had an average age of 18 and 40% were male; all had severe nasal deformities secondary to cleft or craniofacial conditions. The patients rated their preoperative nasal breathing 4/10 on average and cosmetic appearance to be 3/10, while postoperatively, both were rated 9/10.Complications were not noted, except for one superficial infection (unrelated to the graft), and one hypertrophic scar. There were no postoperative admissions. The mechanical and handling properties of Cartiform® and allogeneic rib were appropriate.ConclusionAllogeneic cartilage is an acceptable alternative to autologous cartilage in functional and reconstructive rhinoplasty.



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