Journal archive · Rib, ear and septal grafts · Septum, valve and airway · Outcomes, satisfaction and psychology · Complications and management · Anatomy and nasal analysis · 2021
Cadaveric Costal Cartilage Grafts in Rhinoplasty and Septorhinoplasty: A Systematic Review and Meta-Analysis of Patient-Reported Functional Outcomes and Complications
Pfaff MJ, Bertrand AA, Lipman KJ, Malapati SH, Kim DH, Rezzadeh KS, Roostaeian J.
In the archive as a landmark paper: the core sweep runs 2011–2026, and this one is here because the history of rhinoplasty rests on it · cited on costal cartilage harvest.
From the abstract
“Irradiated cadaveric costal cartilage (CC) has been utilized as an alternative to autologous cartilage (AC) in functional and aesthetic nasal surgery. The impact of graft choice between AC and CC on functional outcomes in rhinoplasty has yet to be studied. A systematic review was performed in PubMed, Embase, and…”
Excerpt; the full abstract is on PubMed.
Citation
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What the rhinoplasty literature says on this paper's topics, cited line by line to PubMed.
Rib, ear and septal grafts
Modern rhinoplasty builds rather than removes, so the operation runs on cartilage: the septum first, then the ear, then the rib, and when none of those will do, a piece of donated rib from a tissue bank.
Septum, valve and airway
Every rhinoplasty is a breathing operation whether it intends to be or not: the septum holds the nose up as well as dividing it, and the narrowest part of the whole airway is the internal valve the surgeon is standing over.
Outcomes, satisfaction and psychology
Rhinoplasty is measured with ten different questionnaires, none of which covers both the way the nose looks and the way it breathes, and the best-developed one has no airway questions at all.
Complications and management
Serious complications after rhinoplasty are rare: infection runs under 1% in the two largest single-surgeon series, pooled rib harvests record no pneumothorax, and the bleeding series record no thromboembolism.
Anatomy and nasal analysis
Before any technique is chosen, the nose has to be read: the bone measured, the cartilage counted, the skin assessed, and the result the patient wants agreed on a photograph that is not yet true.
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