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Posterior prolongation of the cartilaginous nasal septum: an under-utilised source of autologous graft material

Published online by Cambridge University Press:  09 October 2012

P S Phillips ,
R J Harvey ,
R Sacks ,
D Chin  and
G N Marcells
P S Phillips*
Affiliation:
Department of Otolaryngology, St Vincent's Hospital, Sydney, Australia
R J Harvey
Affiliation:
Department of Otolaryngology, St Vincent's Hospital, Sydney, Australia
R Sacks
Affiliation:
Department of Otolaryngology, Concord General Hospital, Sydney, Australia
D Chin
Affiliation:
Department of Otolaryngology, St Vincent's Hospital, Sydney, Australia
G N Marcells
Affiliation:
Department of Otolaryngology, Sydney Hospital, New South Wales, Australia
*
Address for correspondence: Mr P Seamus Phillips, 33 Union Road, Bromley BR2 9SB, UK E-mail: [email protected]
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Abstract

Aim:

To assess the clinical and radiological characteristics of the posterior prolongation of the cartilaginous nasal septum, an under-utilised source of autologous cartilage for nasal reconstruction.

Materials and methods:

Consecutive patients undergoing primary, external approach rhinoplasty were included. The septal cartilage was assessed intra-operatively prior to routine harvest. Cartilage use was recorded and post-operative cosmesis noted. Computed tomography scans from a separate patient group, with no septal surgery, were used to assess septal cartilage dimensions.

Results:

Of the 25 rhinoplasty patients studied, 24 had harvestable septal cartilage, with a posterior prolongation mean length ± standard deviation of 24.3 ± 8.40 mm, mean height of 4.33 ± 0.34 mm and mean width of 1.1 ± 0.35 mm. The mean post-operative cosmesis score was +2.41 ± 0.71 at a mean follow up of 45 ± 8.7 weeks. All 25 radiology patients had visible posterior prolongations on computed tomography (mean length, 18.1 ± 5.1 mm; mean height, 4.2 ± 1.1 mm; mean width 1.5 ± 0.63 mm).

Conclusion:

Harvesting of the posterior prolongation would increase by 25 per cent the cartilage area available for autologous grafts. Endoscopic guidance aids this process. Cartilage is most commonly used for overlay grafts, with good cosmesis. The posterior prolongation is demonstrated on computed tomography, although dimensions may be underestimated.

Keywords

Posterior ProlongationRhinoplastyGraftCartilageSphenoidal Process
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Supplement S1 , January 2013 , pp. S21 - S25
Copyright
Copyright © JLO (1984) Limited 2012

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References

1Keefe, MA, Cupp, CL. The septum in rhinoplasty. Otolaryngol Clin North Am 1999;32:15–36CrossRefGoogle ScholarPubMed
2Sajjadian, A, Naghshineh, N, Rubinstein, R. Current status of grafts and implants in rhinoplasty: Part II. Homologous grafts and allogenic implants. Plast Reconstr Surg 2010;125:99–109eCrossRefGoogle ScholarPubMed
3Daniel, RK. Rhinoplasty: an Atlas of Surgical Techniques. New York, London: Springer, 2002CrossRefGoogle Scholar
4Mladina, R, Krajina, Z. The influence of the caudal process on the formation of septal deformities. Rhinology 1989;27:113–18Google ScholarPubMed
5Van Loosen, J, Van Zanten, GA, Howard, CV, Verwoerd-Verhoef, HL, Van Velzen, D, Verwoerd, CD. Growth characteristics of the human nasal septum. Rhinology 1996;34:78–82Google ScholarPubMed
6Timperley, D, Stow, N, Srubiski, A, Harvey, R, Marcells, G. Functional outcomes of structured nasal tip refinement. Arch Facial Plast Surg 2010;12:298–304CrossRefGoogle ScholarPubMed
7Miles, BA, Petrisor, D, Kao, H, Finn, RA, Throckmorton, GS. Anatomical variation of the nasal septum: analysis of 57 cadaver specimens. Otolaryngol Head Neck Surg 2007;136:362–8CrossRefGoogle ScholarPubMed
8Kim, J, Cho, JH, Kim, SW, Kim, BG, Lee, DC. Anatomical variation of the nasal septum: correlation among septal components. Clin Anat 2010;23:945–9CrossRefGoogle ScholarPubMed
9Yilmaz, MD, Altuntas, A. Congenital vomeral bone defect. Am J Otolaryngol 2005;26:64–6CrossRefGoogle ScholarPubMed
10Melsen, B. Histological analysis of the postnatal development of the nasal septum. Angle Orthod 1977;47:83–96Google ScholarPubMed
11Dogru, H, Yasan, H, Tuz, M. Congenital vomeral bone defect in two thalassemia trait cases. Eur Arch Otorhinolaryngol 2004;261:136–8CrossRefGoogle ScholarPubMed
12Kim, J, Kim, SW, Cho, JH, Park, YJ. Role of the sphenoidal process of the septal cartilage in the development of septal deviation. Otolaryngol Head Neck Surg 2012;146:151–5CrossRefGoogle ScholarPubMed
13Vetter, U, Pirsig, W, Helbing, G, Heit, W, Heinze, E. Patterns of growth in human septal cartilage: a review of new approaches. Int J Pediatr Otorhinolaryngol 1984;7:63–74CrossRefGoogle ScholarPubMed
14Breadon, GE, Kern, EB, Neel, HB 3rd. Autografts of uncrushed and crushed bone and cartilage. Experimental observations and clinical implications. Arch Otolaryngol 1979;105:75–80CrossRefGoogle ScholarPubMed
15Cakmak, O, Buyuklu, F. Crushed cartilage grafts for concealing irregularities in rhinoplasty. Arch Facial Plast Surg 2007;9:352–7CrossRefGoogle ScholarPubMed