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Abstract
Rhinoplasty may require the addition of material to
augment the nose for both aesthetic and functional
indications. Functional reasons for augmentation include
providing structural support for areas deficient of
material, such as the upper or lower lateral cartilages.
Augmentation also may be required for aesthetic reasons
to increase the projection of the nasal dorsum on the
profile view or to augment the nasal tip. In addition,
grafts may be placed to camouflage irregularities of the
bony dorsum and /or of the upper or lower lateral
cartilages.
The use of autologous cartilage grafting has been
demonstrated to be effective in improving both the
functional and cosmetic aspects of the nasal framework.
Cartilage is easily manipulated and can be used to provide
firm support and contouring.
Use of diced cartilage grafts in rhinoplasty surgery
has recently undergone a dramatic resurgence. However,
it was Erol’s “Turkish delight” modification of diced
cartilage grafting for dorsal nasal augmentation that has
recently popularized its use.
Our work aimed to assess the usage of
Surgicel-wrapped diced cartilage in augmentation of
the nose versus classic cartilage technique and
evaluate the efficiency of this new technique versus
the classic one.
To reach our aim, thirty adult patients of both sexes
requiring rhinoplasty operation for dorsal augmentation
were enrolled in this study. Patients were classified into
two groups, fifteen patients each.
Patients of the first group had dorsal augmentation
with Surgicel-wrapped diced cartilage technique. Patients
of the second group had dorsal augmentation with classic
cartilage technique.
As regards the effect of augmentation materials on
the aesthetic results of patients’ photography, the
parameters studied in lateral view in our study were:
nasofrontal angle, nasofacial angle, radix projection,
dorsal projection at rhinion, mid dorsal projection and tip
projection.
In addition these parameters, MRI was done for
some selected cases to evaluate the rate of resorption in
both grafts at 1 month and 6 months.
We found that dorsal augmentation with both grafts
had a statistically significant effect on nasofrontal angle,
nasofacial angle, dorsal projection at rhinion, mid dorsal
projection and tip projection by changing their
measurements toward the normal range; yet concerning
these latter mentioned parameters the difference between
the first (Surgicel-wrapped diced cartilage) and the
second group (Classic cartilage technique) was not
statistically significant.
According to the degree of resorption, Surgicelwrapped
diced cartilage grafts maintained approximately
85% to 90% of their dimensions in MRI. While the Classic
cartilage technique grafts maintained approximately 90%
to 95% of their dimensions in MRI. This suggested that
the degree of resorption was present in both types of
grafts, but it was higher in Surgicel diced cartilage grafts
but the grafts maintained approximately most of its
thickness after 6 months.
At the end we conclude that the advantages of
surgicel diced cartilage graft technique ‘Turkish Delight’
are:
• Its ease of preparation
• Increase the volume of graft available for use
• Avoidance of contour irregularities
• This technique shortens the operative time
significantly by eliminating graft harvest and avoids
donor site morbidity
• This technique is effective for dorsal nasal
augmentation