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Craig S. Murakami, MD; Ted A. Cook, MD; Robert A. Guida, MD

Arch Otolaryngol Head Neck Surg. 1991;117(3):327-330.

Abstract
• Nasal structural reconstruction is a formidable task in cases where there is loss of support to both the nasal dorsum and tip. A multitude of surgical approaches and materials have been used for the correction of the saddle-nose deformity with varying degrees of success. Articulated irradiated rib cartilage inserted through an external rhinoplasty approach was used to reconstruct nasal deformities in 18 patients over a 6-year period. Simultaneous use of a midline forehead flap to reconstruct the overlying soft tissue was required in four cases. Follow-up ranged from 1 to 6 years (mean, 2.8 years). Results were rewarding in most cases with marked improvement in nasal support and airway. Revision and/or replacement secondary to trauma or warping of the graft was required in four cases. None of the patients exhibited infection, extrusion, or noticeable resorption. A description of the surgical technique, review of all the cases, and recommendation for continued use of this graft material are discussed.

(Arch Otolaryngol Head Neck Surg. 1991;117:327-331)

Author Affiliations
From the Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck Surgery, University of Washington School of Medicine, Seattle (Dr Murakami), and Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck Surgery, Oregon Health Sciences University, Portland (Drs Cook and Guida).

Footnotes
Accepted for publication August 7, 1990.

Presented at the Fall meeting of the American Academy of Facial Plastic and Reconstructive Surgery, New Orleans, La, September 23, 1989.

Reprint requests to Department of Otolaryngology—Head and Neck Surgery, OPO-1, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR 97201 (Dr Cook).

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