Septal Cartilage/Ethmoid Bone Composite Graft: A New and Improved Method for the Correction Underdeveloped Nasal Septum in Patients with Short Noses

Aesthetic Plast Surg. 2017 Apr;41(2):388-394. doi: 10.1007/s00266-016-0741-7. Epub 2017 Jan 7.

Abstract

Background: Septal extension grafts are an effective means of extending nasal length in patients with a short nose. However, such grafts can be challenging in patients who only have small quantities of weak septal cartilage, such as some East Asian patients. We developed a rhinoplasty technique using ethmoid bone to create a cartilage-bone complex to overcome this issue, allowing adequate nasal lengthening.

Methods: Sixty-four women with short noses and inadequate septal cartilage determined by preoperative computed tomography underwent septal extension grafting with a cartilage-bone complex between January 2009 and December 2014. Septal cartilage and ethmoid bone were harvested during open rhinoplasty and secured to the septal cartilage.

Results: Most patients were in their twenties or thirties. All patients underwent septal extension grafting using a cartilage-bone complex and dorsal augmentation with silicone implants. Short nasal length, decreased nasolabial angle and increased nostril show, were rectified. There was no recurrence during a mean follow-up period of 12.3 months, although one patient (1.5%) requested revision surgery.

Conclusion: Septal extension grafting with a cartilage-bone complex can be used to correct a short nose, especially in Asians who have relatively small amounts of septal cartilage. The ethmoid bone augments the inadequate septum and provides structural support.

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Keywords: Cartilage–bone complex; Ethmoid bone; Rhinoplasty; Septal cartilage; Septal extension graft; Short nose.

MeSH terms

  • Adult
  • Autografts*
  • Ethmoid Bone / transplantation*
  • Female
  • Humans
  • Middle Aged
  • Nasal Cartilages / transplantation*
  • Nose / surgery*
  • Plastic Surgery Procedures / methods*
  • Prostheses and Implants
  • Rhinoplasty / methods*
  • Silicones
  • Suture Techniques
  • Transplantation, Autologous
  • Young Adult

Substances

  • Silicones