Types of Used Grafts and Postoperative Outcome of Augmentation Rhinoplasty for Saddle Nose Deformity
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- Category: Vol. 82, December 2014
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Types of Used Grafts and Postoperative Outcome of Augmentation Rhinoplasty for Saddle Nose Deformity, NIZAR FAKIH, TURKI ALMUTAIRI, WAEL ELIAS and MOHAMMED A. AL-QARNY
Abstract
Objective: To assess our last 3-year experience with augmentation rhinoplasty regardingtype of used grafts, type of operation and postoperative complications.
Patients and Methods: This study comprised all cases (n=113) of augmentation rhinoplasty (41 males, 36.3%) that were performed at King Fahad Hospital, Jeddah, during January 2010 to December 2012. Their ages ranged from 17 to 43 years (Mean±SD: 29.5±8.8 years). All patients underwent detailed history taking, clinical examination, routine and special investigations, including photography. Patients graded into type I saddle nose deformity (n=30), i.e. mild; type II (n=162), i.e., moderate; and type III (n=34), i.e., severe. All patients were operated upon, using one of either autologous grafts, i.e., iliac crest bone (37 cases), septal cartilage (55 cases), auricular cartilage (3 cases) and costal cartilage (3 cases), or non-autologous graft materials, i.e., Medpor (10 cases), or silicone (5 cases).
Results: Most augmentation rhinoplasty patients were females (72, 63.7%). Allografts were used significantly more than autografts for female patients than for male patients (p=0.004). Allografts were significantly more used for severe nasal deformity (i.e., type III), while autografts were more used for mild and moderate cases of nasal deformities (p<0.001). Trauma constituted 43.4% of the causes of saddle nose. About one fifth of our patients underwent revision rhinoplasties (20.4%). For patients who had allografts, there were significantly more revision rhinoplasties compared with those with autografts (40% vs. 18.3%, respectively, p=0.043). Postoperative complications occurred more significantly among cases with allografts than cases with autografts (p=0.049). Postoperative complications occurred in 13 patients (11.5%). Among patients with allografts four had complications (26.7%) while among patients with autografts, 9 patients had complications (9.2%). The main postoperative complications were displaced graft (5, 4.4%), visible edges (4, 3.5%) and infection (3, 2.7%). Graft absorption occurred in one case (0.9%).
Conclusions: Our patients are mainly young and females with type II saddle nose deformity. Traumatic causes constitute a high proportion for cases of nasal deformity. About one fifth of cases undergo revision augmentation rhinoplasty.