[Rhinoplasty and reconstruction of the nasal dorsum: role of an autologous graft of the concha media].

BACKGROUND: Aesthetic and functional rhinoplasty can improve facial beauty. Surgical procedure may require autogenous grafts. These bone or cartilage grafts are harvested from different parts of the body. The objective of our study is to evaluate the use of nasal concha media as a new type of graft in rhinoplasty.

MATERIALS AND METHODS: Patients consulted for aesthetic as well as for functional problems. They had dorsum deformities. The inclusion criteria had been the achievement of a harmonization surgery of the nasal dorsum, associated or not with another aesthetic or functional rhinoplastic intervention. The grafts are quickly and easily removed by endoscopic endonasal approach under optical control. The removed graft is then shaped and inserted by hidden approach during a rhinoplastic operation. Complications have been noticed for harvesting site and recipient site.

RESULTS: Ten patients have benefited from this new technique from 2002 to 2007. They consulted for aesthetic as well as for functional problems in 9 cases. One person consulted for aesthetic matters only. The removal of these grafts has led to no complication. One case of infection has been noticed, and one dorsum irregularitie has been noticed. Aesthetic and functional results have been analysed over an average step back of two years and show at least comparable results to techniques already published.

CONCLUSION: The concha media seems to serve well as graft material in some indications of rhinoplasty. The primary indication of this type of graft is in the harmonization surgery of the nasal dorsum. These grafts do not replace the other existent autologous grafts, but advantageously complete the technical arsenal of the rhinoplastician. A study involving a wider population should be done to validate the interest of this new type of filling graft in rhinoplasty.