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Reconstruction of a Severely Damaged Cartilaginous Septum with a Bypass L-Strut Graft using Costal Cartilage

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Abstract
Objectives Reconstruction of a weakened septal cartilage is a key procedure for the correction of deformed noses. However, when septal mucoperichondrium dissection is technically challenging, reconstruction of the lower two-thirds of the nose should be performed bypassing the damaged septal cartilage and mucosa. This article summarizes our experience with treating patients with severely damaged septal cartilage with bypass L-strut graft using costal cartilage.

Methods We retrospectively reviewed 26 patients who underwent rhinoplasty using bypass L-strut graft. Autologous costal cartilage was used for creating L-strut in two different ways: (1) by fashioning the L-shaped graft as one unit using the sixth rib cartilage and (2) by integrating a dorsal strut with a columellar strut using slices of the seventh rib cartilage. The caudal strut is fixated to the anterior nasal spine; the dorsal L-strut is placed on the nasal dorsum with no fixation to the nasal bone. Medical records were assessed for demographic, clinical, and treatment information.

Results One-piece-type L-strut graft was used for 11 patients and integrated-type L-strut graft was used for 15 patients. No statistical differences were found in postoperative aesthetic outcomes between the two groups. The postoperative assessment of surgical outcomes was excellent in 10 patients, good in 10, fair in 6, and poor in none. Functionally, all 26 patients experienced improvements in nasal breathing.

Conclusion Bypass L-strut graft using costal cartilage is a useful surgical maneuver of septal reconstruction in particular nasal deformity when the creation of the septal mucoperichondrial pocket is difficult or better to be avoided.
Author(s)
장용주최우리
Issued Date
2021
Type
Article
Keyword
augmentation rhinoplasty - L-shaped implants - costal cartilage grafts - septal cartilage damage - nasal deformity
DOI
10.1055/s-0041-1722957
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7776
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2487745878&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Reconstruction%20of%20a%20Severely%20Damaged%20Cartilaginous%20Septum%20with%20a%20Bypass%20L-Strut%20Graft%20using%20Costal%20Cartilage&offset=0&pcAvailability=true
Publisher
FACIAL PLASTIC SURGERY
Location
미국
Language
영어
ISSN
0736-6825
Citation Volume
37
Citation Number
1
Citation Start Page
92
Citation End Page
97
Appears in Collections:
Medicine > Medicine
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