Septal Harvesting Instruments in Rhinoplasty

Abstract

Septal cartilage is the best graft material for reconstructing the nasal dorsum, columella, and tip. It is the tissue of choice in primary and secondary rhinoplasties, provided that it can be shaped into a desired contour. Because the amount of cartilage obtained with the cutting method using a swivel knife and septal cartilage scissors is insufficient, new instruments and separation methods are needed to compensate for this shortcoming. This article presents two new instruments: the spatula suction dissector and the J & D knife. Using the spatula suction dissector, the septal cartilage was separated from the mucoperichondrium. Then, suspending the hook of the J & D knife on the septal caudal border, a 10-mm marginal incision perpendicular to the cartilage edge is made. The spatula suction dissector and/or D knife can effectively separate the tongue-and-groove articulation. The spatula suction dissector, J & D knife, and separation techniques make it possible to harvest sufficient amounts of cartilage in one piece without leaving any behind during rhinoplasty. There was a need for improved instrumentation to obtain sufficient cartilage than what is currently available. New instruments that made it easier, faster, and safer to harvest the cartilage are presented.