Use of Roof-Shaped Costochondral Cartilage for Correction of Saddle Nose Deformity

Background: Cartilage grafts are routinely used in secondary and post-traumatic rhinoplasty. However, in most cases, there are weak areas in the nasal bones and upper lateral cartilages. The purpose of this study was to seek a solution for keystone area and dorsum of the nose in revision and post-traumatic rhinoplasty cases, and reconstruction of saddle nose deformity including upper lateral cartilage with roof shaped graft. Methods: A retrospective review of reconstructive rhinoplasties performed for saddle nose deformities was conducted. A part of the costochondral graft was carved and thinned (roof graft) for reconstruction of the keystone area and upper lateral cartilages, while another portion was used for making a neo-septal (reconstructed septum) graft and strut graft. Roof graft was capped onto the neo-septal graft with sutures, and this cartilage framework was adapted with fitting the cranial edge of neo-septal cartilage between the nasal bones. Finally strut graft was fixed to the cartilage framework. Results: A significant improvement in nasal shape and overall appearance was achieved in all cases, and 71.42% of patients recovered from nasal obstruction. No gross absorption, graft exposure or recurrence of deformities was observed. Conclusions: Surgical correction of a saddle-shaped nose should be an acceptable and uncomplicated technique, and the cosmetic result should be totally acceptable. There are many management options for a saddle-shaped nose. Use of roof grafts (shrunk gull wing grafts) with neo-septal and strut grafts enables simulation of the internal nasal valve and results in a natural nasal position. The authors has nothing to disclose. Presented at: Rhinoplasty Society Annual Meeting 2017, in San Diego, Califormia Corresponding author: Fatih Irmak; MD, Saglik Bilimleri Universitesi, Sisli Hamidiye Etfal Arastirma ve Uygulama Merkezi; Plastik, Rekonstruktif ve Estetik Cerrahi Klinigi, Halaskargazi cad. Etfal Sokak, Istanbul, Turkiye, dr.fatihirmak@gmail.com ©2018American Society of Plastic Surgeons

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