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Irradiated homologous rib grafts in nasal reconstruction
Dirk J Menger1, Gilbert J Nolst Trenité
1Department of Otorhinolaryngology-Head and Neck Surgery, Center for Facial Plastic and Reconstructive Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands. d.j.menger@amc.uva.nl
Objective:
To assess the long-term efficacy of irradiated homologous rib grafts (IHRGs) for both augmentation and support function in rhinoplasty in general and for specific recipient sites within the nose.
Design:
A retrospective study was conducted at an academic medical center to evaluate the loss of volume and support function of IHRGs in 9 specific recipient sites in the nose.
Results:
We studied 66 patients, with a total of 177 IHRGs, dating back 9 years, with an average follow-up of 51 months. The rate of resorption increased with duration of follow-up. Complete resorption was found in 1 IHRG, and moderate resorption was observed in 55 IHRGs (31%). Resorption was characterized by a loss of support function rather than a loss of volume. Moderate resorption had a negative clinical outcome for shield grafts only.
Conclusions:
Irradiated homologous rib grafts were safe to use in rhinoplasty. In cases requiring a shield graft, IHRGs should be avoided.
