Abstract
BackgroundThe composite graft from the conchal cartilage is a graft that is often used, especially in surgery on the nose, due to its capacity to resolve problems of cover and tissue deficit, arising from the removal of neoplasms or as the result of trauma, burns or following over-aggressive rhinoplasty. We have started to use skin-perichondrium-cartilage graft from the ear to cover large areas of the nose with very satisfying results as well as we describe in the reported clinical case.MethodsThe operation consisted of reconstruction of the cartilaginous nasal septum, which had previously been removed, using two vestibular labial mucosa flaps to reconstruct the mucosa, and cartilage from the ear conch for the cartilaginous septum. After this, the skin edges of the fistula were turned to recreate the inner lining of the nose and form a vascular base of wide area to accept the composite graft. The case concerns a female 74-year old patient who had undergone several oncological surgery for a relapsing basal cell carcinoma on the dorsum of the nose. The operation consisted of reconstruction of the cartilaginous nasal septum using two vestibular labial mucosa flaps to reconstruct the mucosa, and cartilage from the ear conch for the cartilaginous septum.ResultsThe perichondrial cutaneous graft has shown in this surgical case very favorable peculiarities that make it usable even in facial plastic surgery.ConclusionsWe believe that the positive experience that we achieved in the use of composite grafts for the reconstruction of large areas of the nose could be interesting for others surgeons.
Highlights
The composite graft from the conchal cartilage is a graft that is often used, especially in surgery on the nose, due to its capacity to resolve problems of cover and tissue deficit, arising from the removal of neoplasms or as the result of trauma, burns or following over-aggressive rhinoplasty [1,2,3].Complex defects of the nose are aesthetically difficult to repair, the colour, the quality and thickness of the composite-skin graft harvested from the preauricular site compare favourably with the skin of the nose region, even after extensive oncological surgery such asThe technique for removal of the graft is very simple, leaves no trace and does not cause any residual functional deficit [5,6]
The skin edges of the fistula were turned to recreate the inner lining of the nose and form a vascular base of wide area to accept the composite graft (Figure 3,4)
We believe that the positive experience that we achieved in the use of composite grafts for the reconstruction of large areas of the nose could be interesting for others surgeons and will stimulate wider application of the technique described in this report
Summary
The composite graft from the conchal cartilage is a graft that is often used, especially in surgery on the nose, due to its capacity to resolve problems of cover and tissue deficit, arising from the removal of neoplasms or as the result of trauma, burns or following over-aggressive rhinoplasty [1,2,3].Complex defects of the nose are aesthetically difficult to repair, the colour, the quality and thickness of the composite-skin graft harvested from the preauricular site compare favourably with the skin of the nose region, even after extensive oncological surgery such asThe technique for removal of the graft is very simple, leaves no trace and does not cause any residual functional deficit [5,6]. Insertion of the graft is easy and allows rapid solution of surgical problems that would otherwise demand more lengthy reconstruction or the use of microsurgery Working from this point of view, in the last 5 years, we have started to use skin-perichondrium-cartilage graft from the ear to cover large areas of the nose with very satisfying results. Case report The case concerns a female 74-year old patient who had undergone several oncological surgery for a relapsing basal cell carcinoma on the dorsum of the nose It was three years after the last operation and the patient was very keen on a definitive covering of the affected area (Figure 1), which had been made with an epiphysis but which she was no longer able to tolerate. We have started to use skinperichondrium-cartilage graft from the ear to cover large areas of the nose with very satisfying results as well as we describe in the reported clinical case
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