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Anales de Otorrinolaringología Mexicana

2005, Number 3

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Otorrinolaringología 2005; 50 (3)

Analysis of the post-surgical recurrence of the inverted nasal papyloma

Espinosa DR, Rodríguez PMA Villagra SE Hidalgo MR

Language: Spanish
References: 13
Page: 35-43
PDF size: 1137.39 Kb.


ABSTRACT

During the three years in which this study was done, 25 complete and documented cases that were reviewed, underwent a rhinoplasty with costal cartilage graft at the Central Military Hospital of the Mexico City, 8 of which were male patients (32%) and 17 were female (68%).
In 17 patients, tree piece graft was used, image 6 in 5 more patients costal graft of a single piece was used (nasal dorsum), and, finally, in 3 patients an L shaped graft was used. imagen 19 Complications with the costal cartilage graft were present in 4 (16%) of the 25 patients that underwent a rhinoplasty with costal cartilage graft, in 2 of them we did not only used the medullar portion of the costal cartilage and it got deformed; in another case we used an L shaped costal cartilage graft which was placed with a lot tension under the skin and it provoked necrosis; in the last case the patient had an infection of the graft with puss secretion a year and a half after the surgery.
In our results we have found that if we use the cortical part of the costal cartilage in a graft, it has a bigger tendency to deformity even using a center-medullar Kirshner nail, that’s why we recommend the use of the medullar portion of the costal cartilage, we have also identified that with the L shaped grafts,imagen 19 the skin has a lot more tension on the tip of the nose, so we recommend to shape the graft in order to reduce the tension on the nasal tip.
With this study we concluded that when we use the medullar portion of the costal cartilage to shape a graft, it has a minor risk of deformity, the cartilage, in its cortical and medullar portions, has a high risk of deformate itself. It is imperative to avoid excessive tension on the skin of the nasal tip and columella to prevent necrosis.


REFERENCES

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  2. 2.-Daniel, Rollin K. M.D.. “Hispanic Rhinoplasty in the United States, with Emphasis on the Mexican American Nose”. Plastic & Reconstructive Surgery. 112 (1):244-256, July 2003.

  3. 3.-Adams, William P. Jr., M.D. “Reconstruction with lrradiated Homograft Costal Cartilage; Berish Strauch, M.D., and Steven G. Wallach, M.D.”. Plastic & Reconstructive Surgery. 111 (7):2412-2413, June 2003.

  4. 4.-Strauch, Berish M.D.. Wallach, Steven G. M.D. “Reconstruction with Irradiated Homograft Costal Cartilage”. Plastic & Reconstructive Surgery. 111 (7):2405-2411, June 2003.

  5. 5.-Sarifakioglu, Nedim MD. Cigsar, Bulent MD. Aslan, Gurcan MD. K-wire: “A Simple and Safe Method for Internal Stabilization of Costal Cartilage in Lstrut Grafts”. Annals oi Plastic Surgery. 49(4):444, October 2002.

  6. 6.-Sherris, David A. MD. “Relative Benefits of the Versatile Autogenous Costal Cartilage Graft in Septorhinoplasty”. Archives of Facial Plastic Surgery. 4(3):177-179, July/August/September 2002.

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  8. 8.-Sheen, Jack H. M.D. “The Ideal Dorsal Graft: A Continuing Quest”. Plastic & Reconstructive Surgery. 102(7):2490-2493, December 1998.

  9. 9.-Clark, J. Madison MD. Cook, Ted A. MD. “lmmediate Reconstruction of Extruded Alloplastic Nasal Implants With Irradiated Homograft Costal Cartilage”. Laryngoscope. 112(6):968-974, June 2002.

  10. 10.-Toriumi, Dean M. MD. “Autogenous Grafts Are Worth the Extra Time”. Archives of Otolaryngology -- Head & Neck Surgery. 126(4):562-564, April 2000.

  11. 11.-Khurana, Dianne MD. Sherris, David A. MD. “Grafting materials for augmentation septorhinoplasty”. Current Opinion in Otolaryngology & Head & Neck Surgery. 7(4):210, August 1999.

  12. 12.-Agaoglu, Galip M.D.. Erol, O. Onur M.D. “In Situ Split Costal Cartilage Graft Harvesting through a Small Incision Using a Gouge”. Plastic & Reconstructive Surgery. 106(4):932-935, September 2000.

  13. 13.-Erol, O. Onur M.D. “The Turkish Delight: A Pliable Graft for Rhinoplasty”. Plastic & Reconstructive Surgery. 105(6):2229-2241, May 2000.




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