Indications and Long-term Outcomes of Open Augmentation Rhinoplasty with Autogenous L-shaped Costal Cartilage Strut Grafts – A Single Plastic Surgeon’s Experience

Leach, Laura and Shamil, Eamon and Malata, Charles M. (2018) Indications and Long-term Outcomes of Open Augmentation Rhinoplasty with Autogenous L-shaped Costal Cartilage Strut Grafts – A Single Plastic Surgeon’s Experience. Otolaryngologia Polska, 72 (3). pp. 20-29. ISSN 2300-8423

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Official URL: https://doi.org/10.5604/01.3001.0011.7258

Abstract

Introduction: We present a single surgeon’s experience of open augmentation rhinoplasty with autogenous L-shaped costal cartilage grafts, with long-term patient-reported outcome data. We highlight the salient operative steps and outline the peri-operative care required to optimise outcomes. Materials and Methods: A retrospective review of eleven such augmentation rhinoplasties performed between 2008 and 2016 was undertaken. Indications included saddle nose deformity [granulomatosis with polyangiitis (n=7) and relapsing polychondritis (n=1)], post-traumatic nasal collapse (n=1) and advanced cosmetic westernisation of the nose (n=2). Long-term patient-reported outcome was assessed with a patient questionnaire. Results: All patients achieved marked improvement in nasal position, shape and function. There was no cartilage exposure, warping or resorption and no recurrent deformities. One patient’s dorsal graft was fractured two years later during an ophthalmological procedure and the deformity was re-corrected successfully, again with the above technique. Average follow up was 5.2 years. Of the nine patients who responded to the follow-up questionnaire, 100% were satisfied with their nasal appearance. 100% of responders at follow-up reported that they have had no problems relating to their nose (n=9). Discussion L-shaped costal cartilage grafts provided a reliable, reproducible approach in augmentation rhinoplasty for disparate indications (inflammatory, traumatic and cosmetic) in the hands of a low-volume operator. With careful patient selection and planning, this technique can provide pleasing aesthetic outcomes and high patient satisfaction, with good long-term outcomes.

Item Type: Journal Article
Keywords: augmentation rhinoplasty, costal cartilage grafts, autoimmune inflammatory disease, granulomatosis with polyangiitis, relapsing polychondritis, screw fixation of grafts
Faculty: Faculty of Medical Science
Depositing User: Ian Walker
Date Deposited: 31 Jul 2018 12:39
Last Modified: 24 Apr 2019 14:58
URI: http://arro.anglia.ac.uk/id/eprint/703456

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