Tip Graft and Columellar Strut Using Dorsal Osseocartilaginous Hump

Abstract

Background: Although, different grafts are used for nasal tipplasty in cases with under projected or ill defined tip, the selectionof a graft material, which provides sufficient amount oftissue with least donor site morbidity and low recipient sitecomplication is challenging. The objectives of the presentstudy were to examine the usefulness of cartilaginous dorsumas a proper material for tip graft, and to introduce the cartilaginousdorsum as an acceptable material for columellar strut.Methods: Fifty six (18 males and 38 females) patients wereoperated for augmentation tip plasty and hump reduction from2004 to 2008. The tailored cartilaginous or ostecartilaginousdorsum was used as a tip graft or columellar strut in 35 and 21cases, respectively. The cartilaginous framework was exposedusing open or close rhinoplasty approach in 41 and 15 cases,respectively. The patients were followed for 12- 36 months.Cosmetic outcomes and patients' satisfaction were obtainedusing qualitative measures.Results: The percentage of patients with very improved, improved,unchanged or unacceptable aesthetic outcome were39.29%, 50%, 3.57% and 7.14%, respectively. Moreover, thepercentages of very satisfied, satisfied, indifferent and unsatisfiedpatients were 66%, 18%, 9%, and 7%, respectively.Conclusion: The procedure provides a well-defined nasal tipwith no evidence of bifidity, angularity, or cartilage graft visibilityand displacement. The use of dorsal osteocartilaginousgraft offers outstanding advantages including ease of harvest,mould, fix, and low resorption.

Keywords

• Rhinoplasty
• Graft
• Cartilage