Long-term Use and Follow-up of Irradiated Homologous Costal Cartilage Grafts in the Nose

2009 ◽  
Vol 11 (6) ◽  
Author(s):  
Russell W. H. Kridel ◽  
Faramarz Ashoori ◽  
Edmund S. Liu ◽  
Carol G. Hart
Keyword(s):  
Costal Cartilage ◽  
Cartilage Grafts

scholarly journals Indications and Long-term Outcomes of Open Augmentation Rhinoplasty with Autogenous L-shaped Costal Cartilage Strut Grafts – A Single Plastic Surgeon’s Experience

2018 ◽  
Vol 72 (3) ◽  
pp. 20-29 ◽  
Author(s):  
Laura Leach ◽  
Eamon Shamil ◽  
Charles M. Malata
Keyword(s):  
Costal Cartilage ◽  
Relapsing Polychondritis ◽  
Patient Reported Outcome ◽  
Patient Questionnaire ◽  
Long Term Outcomes ◽  
Augmentation Rhinoplasty ◽  
Cartilage Grafts ◽  
Patient Reported

Introduction We present a single surgeon’s experience of open augmentation rhinoplasty with autogenous L-shaped costal cartilage grafts, with long-term patient-reported outcome data. We highlight the salient operative steps and outline the peri-operative care required to optimise outcomes. Materials and Methods A retrospective review of eleven such augmentation rhinoplasties performed between 2008 and 2016 was undertaken. Indications included saddle nose deformity [granulomatosis with polyangiitis (n=7) and relapsing polychondritis (n=1)], post-traumatic nasal collapse (n=1) and advanced cosmetic westernisation of the nose (n=2). Long-term patient-reported outcome was assessed with a patient questionnaire. Results All patients achieved marked improvement in nasal position, shape and function. There was no cartilage exposure, warping or resorption and no recurrent deformities. One patient’s dorsal graft was fractured two years later during an ophthalmological procedure and the deformity was re-corrected successfully, again with the above technique. Average follow up was 5.2 years. Of the nine patients who responded to the follow-up questionnaire, 100% were satisfied with their nasal appearance. 100% of responders at follow-up reported that they have had no problems relating to their nose (n=9). Discussion L-shaped costal cartilage grafts provided a reliable, reproducible approach in augmentation rhinoplasty for disparate indications (inflammatory, traumatic and cosmetic) in the hands of a low-volume operator. With careful patient selection and planning, this technique can provide pleasing aesthetic outcomes and high patient satisfaction, with good long-term outcomes.

Long-term Use and Follow-up of Irradiated Homologous Costal Cartilage Grafts in the Nose

2009 ◽  
Vol 11 (6) ◽  
pp. 378-394 ◽  
Author(s):  
Russell W. H. Kridel ◽  
Faramarz Ashoori ◽  
Edmund S. Liu ◽  
Carol G. Hart
Keyword(s):  
Costal Cartilage ◽  
Cartilage Grafts

scholarly journals Nasal correction in nasomaxillary hypoplasia (Binder’s syndrome): An optimised classification and treatment

2016 ◽  
Vol 49 (03) ◽  
pp. 314-321 ◽  
Author(s):  
Venkata Ramana Yamani ◽  
Shakuntala Ghosh ◽  
Shreekumar Tirunagari
Keyword(s):  
Costal Cartilage ◽  
Functional Results ◽  
En Bloc ◽  
Cartilage Grafts ◽  
Long Term Stability ◽  
Alar Base ◽  
Rare Congenital Disorder ◽  
Nasal Floor ◽  
The Individual

ABSTRACT Background: Nasomaxillary hypoplasia is a rare congenital disorder involving the central face. It imparts a distinctive appearance to the individual face as the age advances. Severity of the disorder varies, so do the manifestations. Methods: This was a retrospective study conducted on the records and photographic data of 560 rhinoplasty cases performed between 2006 March and 2016 March. About 16 cases of nasomaxillary hypoplasia were selected from the group and they were classified based on the severity of the features. Surgical correction performed in each group was detailed. Results: Three percent of the 560 rhinoplasties performed in our centre turned out to be cases of Binder's syndrome. Nasal correction with locoregional autologous cartilage grafts was sufficient in mild cases. Loco-regional cartilage grafts along with costal cartilage grafts were needed for moderate and severe cases. Anterior nasal floor along with alar base augmentation was performed to achieve a proper aesthetic profile in moderate and severe cases. Post-operative results were excellent in mild and moderate cases and acceptable in severe cases. Discussion: We attempted to correct the deformity only after growth of the nose and maxilla was completed. We used cartilage grafts as a mainstay as cartilage has long-term stability without resorption unlike bone grafts. Instead of following en bloc technique of cartilage assembly, we have reconstructed the nasal dorsum, columella and tip separately as this principle is more functionally acceptable with less warping or stiffness of the nose. Importance was given to proper anchorage of grafts. Conclusion: We have attempted to put together the various features into three categories of mild/moderate/severe based on previous anthropometric studies of nasal anatomical parameters. The second objective of our study was to advise a logical surgical protocol for each group so that future surgeons can follow an easy surgical guideline to attain optimal cosmetic and functional results.

Cartilage grafts in dorsal nasal augmentation of traumatic saddle nose deformity: A long-term follow-up

2009 ◽  
Vol 119 (11) ◽  
pp. 2111-2117 ◽  
Author(s):  
Johnny Mao ◽  
Michael Carron ◽  
Senja Tomovic ◽  
Kailash Narasimhan ◽  
Shannon Allen ◽  
...  
Keyword(s):  
Saddle Nose ◽  
Cartilage Grafts ◽  
Saddle Nose Deformity ◽  
Long Term Follow Up ◽  
Dorsal Nasal Augmentation ◽  
Nose Deformity ◽  
Nasal Augmentation

scholarly journals 307 * LONG-TERM FOLLOW-UP OF TRACHEOPLASTY USING AUTOLOGOUS PERICARDIAL PATCH AND STRIPS OF COSTAL CARTILAGE

2013 ◽  
Vol 17 (suppl 2) ◽  
pp. S144-S144
Author(s):  
A. Yazdanbakhsh ◽  
L. B. V. Rijssen ◽  
D. R. Koolbergen ◽  
A. M. Konig ◽  
M. Hazekamp
Keyword(s):  
Costal Cartilage ◽  
Pericardial Patch ◽  
Autologous Pericardial Patch ◽  
Long Term Follow Up

scholarly journals Namaste (counterbalancing) technique: Overcoming warping in costal cartilage

2015 ◽  
Vol 48 (02) ◽  
pp. 123-128 ◽  
Author(s):  
Kapil S. Agrawal ◽  
Manoj Bachhav ◽  
Raghav Shrotriya
Keyword(s):  
Large Volume ◽  
Simple Technique ◽  
Costal Cartilage ◽  
Cartilage Grafts ◽  
Major Disadvantage

ABSTRACT Background: Indian noses are broader and lack projection as compared to other populations, hence very often need augmentation, that too by large volume. Costal cartilage remains the material of choice in large volume augmentations and repair of complex primary and secondary nasal deformities. One major disadvantage of costal cartilage grafts (CCG) which offsets all other advantages is the tendency to warp and become distorted over a period of time. We propose a simple technique to overcome this menace of warping. Materials and Methods: We present the data of 51 patients of rhinoplasty done using CCG with counterbalancing technique over a period of 4 years. Results: No evidence of warping was found in any patient up to a maximum follow-up period of 4 years. Conclusion: Counterbalancing is a useful technique to overcome the problem of warping. It gives liberty to utilize even unbalanced cartilage safely to provide desired shape and use the cartilage without any wastage.

scholarly journals Long-term follow-up of tracheoplasty using autologous pericardial patch and strips of costal cartilage†

2014 ◽  
Vol 47 (1) ◽  
pp. 146-152 ◽  
Author(s):  
Aria P. Yazdanbakhsh ◽  
Lennart B. van Rijssen ◽  
David R. Koolbergen ◽  
Astrid König ◽  
Bas A.J.M. de Mol ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Pericardial Patch ◽  
Autologous Pericardial Patch ◽  
Long Term Follow Up

S279 – Augmentation Rhinoplasty with Permacol and Cartilage Grafts

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P168-P168 ◽  
Author(s):  
Thirupathirajan Thinakararajan ◽  
Venkat R Srinivasan
Keyword(s):  
Patient Satisfaction ◽  
Senior Author ◽  
Augmentation Rhinoplasty ◽  
Historical Cohort ◽  
Cartilage Grafts ◽  
Satisfactory Outcome ◽  
Long Term Follow Up ◽  
The Mean

Objectives Assessment of outcome and patient satisfaction following augmentation rhinoplasty with cartilage & Permacol and safety of Permacol. Methods Permacol is a biomaterial derived from porcine dermis, modified by chemical processing. Patients with Permacol augmentation were compared with a historical cohort of patients who had cartilage augmentation. Patients, who had cartilage grafts, were retrospectively reviewed for a period of 3 years, from 2001 to 2004. Patients in the Permacol group were prospectively studied from 2003 to 2006. The senior author performed all operations. All the patients had supra-tip depression. The outcome was measured by clinical assessment, evaluation of photographs, and patient satisfaction. Results A total 24 patients had augmentation rhinoplasty-12 with cartilage and 12 with Permacol. Their age ranged from 19 to 54 years (mean 30). The mean follow-up for cartilage grafts was 33 months and for Permacol 26 months, with a minimum of 12 months for both groups. Cartilage grafts were harvested from the septum in 7 patients and from the pinna in 5 patients. All 12 patients with cartilage augmentation had satisfactory outcome. In the Permacol group, 11 out of 12 were satisfactory with the outcome. In 1 patient, Permacol graft extruded within 2 months. Conclusions Permacol graft compared very well, in terms of outcome and safety, with cartilage for augmentation of nasal dorsum. Apart from 1 case of extrusion (8%), there were no other complications. Permacol graft is readily available and easy to handle and contour. Long-term follow-up is needed for further assessment.

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis
Keyword(s):  
Mental Health ◽  
Mental Disease ◽  
Brain Disorders ◽  
Social Stressors ◽  
Labor Education ◽  
Mental Diseases ◽  
Long Term Follow Up ◽  
Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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