The use of calvarial bone in nasal reconstruction.

OBJECTIVE: To demonstrate the utility of calvarial bone as a primary graft choice in nasal reconstruction.

DESIGN: Case series.

SETTING: Academic tertiary care center. PATTERN: Thirty-five consecutive patients who underwent split calvarial bone grafting to the nasal dorsum between June 1988 and September 1993 and who had post-operative follow-up.

OUTCOME MEASURES: Serial clinical examination to assess volume loss, movement of the graft, and complications. Standardized photographs to assess nasal contour.

RESULTS: Fixation of the graft was accomplished using a technique that promotes bone-to-bone healing without fixation screws or wires. The most common complication was seroma or hematoma of the scalp (8%). There were no dural tears or intracranial complications. Long-term donor site morbidity consisted of one case of local alopecia (2.8%). A good nasal contour was achieved in 97% of patients.

CONCLUSION: Based on the experimental evidence reviewed and our clinical experience, split calvarial bone is recommended as a material of choice for nasal dorsal reconstruction.