Rhinoplasty by using Conchal Graft
Jubilee Hospital Trivandrum.
The common procedures to reconstruct a severe saddle-nose deformity are by using nasal septal cartilage, auricular cartilage, costal cartilage, iliac crest, or silastic implants.
The silastic implants are rarely used in my patients because the use of autologous cartilage still provides the best resistance to infection and a low degree of resorption.
When the septum has been removed during a previous surgery or if their is not sufficient amounts of septal cartilage, surgeons must obtain the cartilage for grafts from an alternative source, either the ear or rib. Ear cartilage grafts are only used if the nasal septal cartilage has already been depleted. Ear cartilage is suitable for many applications in Rhinoplasty.
The auricular conchal cartilage is easy to harvest, shape and can provide grafts to reconstruct the various anatomical components of the nasal pyramid. If enough graft material is not available from one side, one can take conchal cartilage from the other side and use as sandwich graft.
The conchal grafts are taken by an incision made on the Preauricular surface of the ear. I prefer to take the graft from the non dominant ear of the patient.Meticulous cross-hatching makes the curved grafts as per the need.
The graft is usually taken from the central depression in the ear called the conchal cavum. However, it can be taken from any place except the borders (helix). This maintains the shape of the ear.
Typically after the cartilage removal, a pressure type dressing in the ear concha and a mastoid bandage is kept for 24-48 hrs .A small drain is placed in situ to prevent any heamatoma.
After the dressing is removed you might have some bruising in the ear but the incisions are well hidden and heal easily. I use absorbable sutures. After healing is complete, the patients usually do not even notice that it is missing.
Make Physical Consultation with-
Dr.K.O.Paulose FRCS, Consultant ENT Surgeon
Jubilee Hospital Trivandrum Kerala South India
Tel. 0471 3080300 , 0471 233 4561
OP Clinic Mon-Wed-Friday 9 AM -12 Noon
Operation Days Tues-Thu-Saturday 8 AM -2 PM
To Reach Jubilee Hospital: jubileehospitaltrivandrum