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Mack L. Cheney, MD; Richard E. Gliklich, MD

Arch Otolaryngol Head Neck Surg. 1995;121(6):643-648.

Abstract
Objective
To demonstrate the utility of calvarial bone as a primary graft choice in nasal reconstruction.

Design
Case series.

Setting
Academic tertiary care center.

Pattern
Thirty-five consecutive patients who underwent split calvarial bone grafting to the nasal dorsum between June 1988 and September 1993 and who had postoperative follow-up.

Outcome Measures
Serial clinical examination to assess volume loss, movement of the graft, and complications. Standardized photographs to assess nasal contour.

Results
Fixation of the graft was accomplished using a technique that promotes bone-to-bone healing without fixation screws or wires. The most common complication was seroma or hematoma of the scalp (8%). There were no dural tears or intracranial complications. Longterm donor site morbidity consisted of one case of local alopecia (2.8%). A good nasal contour was achieved in 97% of patients.

Conclusion
Based on the experimental evidence reviewed and our clinical experience, split calvarial bone is recommended as a material of choice for nasal dorsal reconstruction.

(Arch Otolaryngol Head Neck Surg. 1995;121:643-648)

Author Affiliations
From the Department of Otolaryngology, Division of Facial Plastic and Reconstructive Surgery, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Mass.

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