AUTOGENOUS RIB GRAFT FOR NASAL RECONSTRUCTION, PANORAMIC REVISION

Abstract

Introduction: It is remarkable the increase in the last decades of rhinoplasties for aesthetic and functional reasons. Some congenital, iatrogenic or traumatic etiologies originate a deficient or deformed nasal dorsum that needs correction with a dorsal augmentation. A deficient osteocartilaginous dorsum is the most frequent drawback requiring augmentation with graft material. Objective: to detail the current information related to autogenous rib grafting for nasal reconstruction. Methodology: a total of 33 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 24 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, SciELO, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: graft, autologous, rhinoplasty, costal, nose, deformity. Results: Costal cartilage is a remarkable material in reconstructive septorhinoplasty, mainly in revision surgery because it requires large amounts of tissue. This autologous material presents a low incidence of complications. With increasing age it is more likely that this cartilage is calcified, so its procurement and manipulation will be more complex. The most commonly used cartilage is the septal cartilage, however, in several cases the septal cartilage may not be sufficient for the intervention, it may be very deteriorated or absent, so the costal cartilage is an essential support for very damaged noses or in case of secondary surgeries. Conclusions: the graft of choice is the septal cartilage due to its simple procurement and physical elastic properties, however its ration is scarce. Rib cartilage is a graft that provides a lot of material. The costal cartilage graft is a fruitful tool when facing complex surgeries or nasal reconstructions. Autologous rib cartilage graft is a viable alternative in reconstructive septorhinoplasty. The surgical technique is not complicated and has a low complication rate. KEY WORDS: autologous graft, rhinoplasty, nasal aesthetics, nasal deformity.