Abstract
Defects of the nasal ala are challenging to reconstruct, given its complex three-dimensional structure. Successful repair of these defects needs to provide aesthetic symmetry and preserve nasal function. A wide variety of reconstructive options have been described for nasal ala defects, ranging from skin grafts to locoregional flaps, and also includes the auricular composite graft. However, there are currently no comprehensive guidelines for nasal ala repair, and the versatile role of the auricular composite graft has not been well defined. In this review, we aim to provide a comprehensive algorithm to guide repair of nasal ala defects. Additionally, we compare our experience using the auricular composite graft with the available literature to better define its utility in nasal ala repair.
Highlights
Defects of the nasal ala are challenging to reconstruct, given its complex threedimensional structure
We aim to provide a comprehensive algorithm to guide repair of nasal ala defects
The technique of using autologous skin with underlying auricular conchal cartilage for nasal reconstruction was first introduced by Konig in 1902.4 Since its description, the auricular composite graft has been used in nasal reconstruction for a variety of purposes
Summary
Defects of the nasal ala are challenging to reconstruct, given its complex threedimensional structure. The nasal ala consists of three anatomically distinct layers— the external skin, the internal nasal lining, and the fibrofatty middle portion This middle portion needs to be reconstructed with a nonanatomic graft as this unique tissue cannot be replaced. The technique of using autologous skin with underlying auricular conchal cartilage (composite graft) for nasal reconstruction was first introduced by Konig in 1902.4 Since its description, the auricular composite graft has been used in nasal reconstruction for a variety of purposes It has been proven effective in vestibular stenosis repair, nasal valve insufficiency, external skin and cartilage reconstruction, and intranasal lining repair in full thickness nasal defects.[5,6,7,8] Auricular composite grafting is an attractive option for nasal ala reconstruction given that the conchal skin is a good color match and the conchal cartilage mimics the natural contour of the ala.[9] the surgical technique can be performed quickly with relative ease and leaves little donor site morbidity for the patient.[2,10]. We will describe our outcomes using the auricular composite graft, and help define its role in this reconstructive algorithm
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