The conchal cartilage graft in nasal reconstruction

Graft selection remains a problem in nasal reconstruction, where the use of autologous cartilage still provides the best resistance to infection and a low degree of resorption. As the nasal septum is often absent or insufficient in such patients, the auricular concha offers a valid alternative. A group of 53 patients suffering from developmental iatrogenic and post-traumatic nasal pathologies were treated surgically by means of conchal grafts. Detailed examination of the anatomical defects presented by the patients made it possible to plan the removal of grafts from the area of the auricular concha with great precision. Guidelines were developed for the areas of the cymba concha and cavum concha to be used as sources for some types of commonly used graft. The technique described made it possible to restore the anatomically deficient structures with satisfactory aesthetic and reconstructive results. The use of cartilage grafts also addressed functional breathing problems. The auricular concha is easy to shape and can provide grafts to reconstruct the various anatomical components of the nasal pyramid. To this end, it proves very useful to save as much cartilage as possible and to pinpoint affinities between some areas of the concha and the structures to be reconstructed.