A New Technique to Correct Saddle Nose Deformity in Failure of Diced Cartilage Grafts: Diced Cartilage Flap.

BACKGROUND: To correct saddle nose deformity, diced cartilage grafts have been commonly used over the past decade. However, following the correction of saddle nose deformity with diced cartilage graft, some problems like graft absorption or displacement may occur, which require revision surgery. Here, a new technique is presented for correcting saddle nose deformity when diced cartilage graft fails.

METHODS: Twelve cases were admitted to my clinic with complaints of nasal dorsal irregularity and depressions, asking for tertiary rhinoplasty. Seven (four women and three men) of these patients, who had a gap smaller than 1 cm in the lower 1/3rd of nasal dorsum, were selected for the described technique. After the nasal dorsum is undermined through the supra-perichondrial and subperiosteal plane, the diced cartilage island attached to the nasal dorsal skin is released distally until the island can be transposed to the tip area. This island attached to the nasal dorsal skin proximally, is formed as a flap and moved caudally as an advancement flap and sutured to the posterior of the dome area. The patients were followed for minimum 1 year (12-20 months) with intervals of 3 months.

RESULTS: All the patients and also the surgeon were satisfied with the results. No complications such as resorption of the grafts were observed in any of the cases.

CONCLUSION: This is an alternative, new, practical technique for correcting saddle nose deformity in the lower 1/3 of the nasal dorsum, in which the diced cartilage graft technique has failed to correct. In addition, tip projection and upward rotation can be achieved with this technique.

LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to 46 Authors www.springer.com/00266 .