Use of cartilaginous autografts in nasal surgery: 8 years of experience

Although the cartilaginous autografts ale one of the tissues more utilized in nasal surgery, a comparative study does not exist to determine which are better options and their precise indications. It is for this reason that a histopathologic analysis was carried out comparing the characteristics and proper-ties of the four principal cartilages that are utilized in aestheti c functional surgery of the nose. Considering these particularities, the pr ecise indications for the employment of the different cartilage as nasal au tografts were determined. Of 1120 aesthetic functional rhinoplasties during a period of 8 years, 930 (83 percent) required cartilaginous autografts, 8 6 percent were primary, 11 percent were secondary, and 3 percent had two or more surgeries. Eighty-three percent of the grafts used were from nasal se ptum, 12 percent from the auricle, 3 percent fi-om alar cartilages, and 2 p ercent from the rib. The anatomic sites in which they were employed consist ed of the following: 64 percent between the medial crura, 28 percent as in Sheen's graft, 19 percent in the nasal dorsum, 8 percent as spreader grafts , 8 per-cent as in Peck's graft, and 3 percent in the rim to improve alar c ollapse. We followed at all times the previous indications for obtaining an d placing the nasal autografts. Eighty-four per-cent of the patients were t otally satisfied and only 8 percent required a second surgical procedure to achieve the results desired. Based on this study, it is recommended to uti lize the cartilaginous autografts in nasal surgery considering three parame ters: the physical and histologic characteristics of each cartilage, the an atomic site in which they are to be placed, and the effect desired with the ir application.