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Modified Back-to-Back Autogenous Conchal Cartilage Graft for Caudal Septal Reconstruction

2011; American Medical Association; Volume: 13; Issue: 1 Linguagem: Inglês

10.1001/archfacial.2010.107

1538-3660

Cody A. Koch, Oren Friedman,

Cleft Lip and Palate Research

To report our experience with the use of a modification of the back-to-back autogenous conchal cartilage graft, used as a medial crural extension graft, for reconstruction of the caudal septum.Retrospective review of all patients undergoing caudal septal reconstruction using a modification of the back-to-back conchal cartilage graft from January 1, 2007, through June 1, 2009, at a tertiary referral center. Photodocumentation of all patients was obtained preoperatively and postoperatively. Patients were asked to subjectively rate their functional and cosmetic outcomes at each follow-up visit.Eight patients underwent caudal septal reconstruction with the modified back-to-back conchal cartilage graft during the time period studied. Six patients underwent caudal septal reconstruction via external septorhinoplasty while 2 patients underwent an endonasal approach. The median duration of follow-up was 12 months. At the last follow-up, patients rated their breathing as normal in 7 of 8 cases and improved, but not to normal, in 1 of 8 cases. Cosmesis was rated as excellent in 7 of 8 cases and good in 1 of 8 cases. There were no postoperative complications.Modification of the back-to-back autogenous conchal cartilage graft used as a medical crural extension graft should be considered for reconstruction of the caudal septum in the cartilage deficient nose. The technique produces reliable outcomes with minimal donor site morbidity.