Auricular Cartilage Grafting

Auricular Cartilage (Pinna Cartilage) Graft Harvesting in Revision Rhinoplasty

Why auricle cartilage graft is needed in revision rhinoplasty operations?



Auricular Cartilage (Auricular Cartilage) Graft in Revision Rhinoplasty - Why auricle cartilage graft is needed in revision rhinoplasty operations? - When auricle cartilage graft is used in revision nose job surgeries? - How to taken the cartilage graft from the auricle (auricular conchal cartilage)? - Recommendations after the cartilage graft taken from the auricle  - Does the shape of the auricle change after the cartilage graft taken from the auricle? - Why is a cartilage graft removed from the auricle? - In which cases is the cartilage graft used from the auricle? - Use of cartilage graft taken from the ear for revision nose aesthetic - Cartilage graft taken from the auricle - What to do after taken of the cartilage graft from the auricle? - Auriculer conchal cartilage - Use of auricular conchal cartilage in nose aesthetic surgery


Especially in patients who have previously undergone surgery and who do not have sufficient cartilage support tissue on the nasal septum or nose, the patient's own auricle cartilage or rib cartilage can be used when performing revision nose operations. In the photo above, five days ago, cartilage grafts taken from the patient's right auricle, pinna seem to be back.

When auricle cartilage graft is used in revision nose job surgeries?

Nasal surgeries that may be required to remove cartilage from the auricle can be summarized as follows:


• revision nose surgery (in order to place cartilage grafts on areas of the nose or asymmetric areas)
• revision nose tip aesthetics (ears of cartilage is not ideal in the construction of the nasal tip support because it is soft. However, it can be used to remove the nose wing asymmetries, to support the nasal wings and to widen the nose tip).
• repair of the nasal septum perforation (the ears of the auricle is curved and the septum in the nasal septum can cause the septum curvature when placed on the midline alone in patients with a hole.
 
Normally, as the donor material in nasal surgery, the patient's own septal cartilage is often the choice. However, cartilage grafts obtained from the auricle can be used as a safe, effective and versatile alternative (source link >> Auricular cartilage grafts and nasal surgery).
 
During the rhinoplasty operation, additional cartilage material may be needed to expand the nose (Augmentation Rhinoplasty). In some cases, the cartilage tissue that is greasy to enlarge the volume of the nose may need to be removed from the noseband and ribs. Volume enhancement may be required for both aesthetic and functional indications (source links >> Augmentation Rhinoplasty: Background, History of the Procedure ... / Cartilage Grafts for Nasal Reconstruction Uses and Indications ...).
 
Cartilage obtained from the auricle can be used in different surgical procedures in the area of the kbb and in our body. In the stenosis and injuries of the larynx and trachea; grafts obtained from the auricle can be used (source link >> Auricular cartilage grafts in laryngotracheal reconstruction. - NCBI).
 
he cartilage grafts obtained from the auricle can also be used to close the eardrum holes or to repair the other auricle or the external ear canal (source link >> A New Technique for Conchal Cartilage Harvest - NCBI - NIH).

How to taken the cartilage graft from the auricle (auricular conchal cartilage)?


Auricular Cartilage (Auricular Cartilage) Graft in Revision Rhinoplasty - Why auricle cartilage graft is needed in revision rhinoplasty operations? - When auricle cartilage graft is used in revision nose job surgeries? - How to taken the cartilage graft from the auricle (auricular conchal cartilage)? - Recommendations after the cartilage graft taken from the auricle  - Does the shape of the auricle change after the cartilage graft taken from the auricle? - Why is a cartilage graft removed from the auricle? - In which cases is the cartilage graft used from the auricle? - Use of cartilage graft taken from the ear for revision nose aesthetic - Cartilage graft taken from the auricle - What to do after taken of the cartilage graft from the auricle? - Auriculer conchal cartilage - Use of auricular conchal cartilage in nose aesthetic surgery

 The aim of the cartilage graft removal from the auricle is to obtain an adequate amount for reconstruction and to minimize the change in ear shape. Cartilage can be taken with anterior or posterior approach. Each method has advantages and disadvantages.
 
The posterior approach offers the advantage of scar concealment; however, the cymba region that can be removed may be limited in the amount of cartilage. On the contrary, the anterior approach may cause a striking wound. However, when the cartilage is collected, the anterior approach provides a view that facilitates the protection of the ear structure. In addition, it is possible to obtain larger amounts of cartilage.

Conchal cartilage typically preferred when the ear cartilage is used. Several factors should be taken into account when removing conchal cartilage: a sufficient amount of harvest, cartilage without being damaged during surgery, and the absence of ear-shaped postoperative changes (source links >> The conchal cartilage graft in nasal reconstruction. - NCBI / Donor site morbidity post-conchal cartilage grafting. - NCBI).
 
The posterior approach for cartilage removal from the auricle can provide better cosmetic results, allowing the incision site to be less visible, but a limited amount of cartilage can be harvested. The anterior approach allows for easier dissection with easier visible locations to maintain the ear shape. 


Auricular Cartilage (Auricular Cartilage) Graft in Revision Rhinoplasty - Why auricle cartilage graft is needed in revision rhinoplasty operations? - When auricle cartilage graft is used in revision nose job surgeries? - How to taken the cartilage graft from the auricle (auricular conchal cartilage)? - Recommendations after the cartilage graft taken from the auricle  - Does the shape of the auricle change after the cartilage graft taken from the auricle? - Why is a cartilage graft removed from the auricle? - In which cases is the cartilage graft used from the auricle? - Use of cartilage graft taken from the ear for revision nose aesthetic - Cartilage graft taken from the auricle - What to do after taken of the cartilage graft from the auricle? - Auriculer conchal cartilage - Use of auricular conchal cartilage in nose aesthetic surgery


The patient has a cartilage graft from the conchal cartilage 5 days before and after you see the image before and after the images.
 
While I usually take cartilage from the auricle, I prefer to take a cartilage graft (posterior technique) behind the auricle, a concealed incision method. In order to remove graft from the auricle of the ear, local anesthetic infiltration is performed on the anterior and posterior part of the auricle and without touching the cartilages which are responsible for the curvature of the auricle; cartilage graft is taken from cartilage tissue in concha and small amount of cymba. After the procedure, the full layer of antibiotic impregnated gauze-like materials are stitched on both sides, in order to prevent the formation of dead spaces by adhering to the individual skin surfaces. In the photos, these gauze diapers are cut and the sutures are seen.

During revision rhinoplasty operations, surgeons generally act with the idea of ​​minimal surgical trauma and minimal surgical risk. When patients need additional cartilage for the treatment of existing nasal deformities, the patient's rib or auricle cartilage can be used as a graft donor area. When a limited amount of cartilage is needed, cartilage grafts can be obtained from the auricle of the patient, especially for the purpose of supporting the nasal wings or eliminating sunken areas. In order not to change the shape of the auricle, cartilage grafts can be obtained only from the concha region. I usually prefer the incision made behind the auricle. Cartilage grafts can be obtained from the auricle under local anesthesia or under general anesthesia before the rhinoplasty operation. Since the cartilages obtained from here are generally curved and soft, they are not as suitable as rib cartilage in structuring the cartilage support of the nasal tip. After the incision made after the skin-subcutaneous local anesthetic infiltration in the front and back of the ear pinna where the cartilage will be removed, the cartilage incision and elevator are made with the help of scissors and scalpel. After the graft is removed, the skin incision is stitched and antibiotic impregnated gauze can be sutured full-layer on the front and back of the ear pinna in order to close the dead space between the two skins and to prevent hematoma. After 5-7 days, these gauze are removed by removing the stitches and the wound site is evaluated. The patient's photos above are from one week after the procedure.

Recommendations after the cartilage graft taken from the auricle


Auricular Cartilage (Auricular Cartilage) Graft in Revision Rhinoplasty - Why auricle cartilage graft is needed in revision rhinoplasty operations? - When auricle cartilage graft is used in revision nose job surgeries? - How to taken the cartilage graft from the auricle (auricular conchal cartilage)? - Recommendations after the cartilage graft taken from the auricle  - Does the shape of the auricle change after the cartilage graft taken from the auricle? - Why is a cartilage graft removed from the auricle? - In which cases is the cartilage graft used from the auricle? - Use of cartilage graft taken from the ear for revision nose aesthetic - Cartilage graft taken from the auricle - What to do after taken of the cartilage graft from the auricle? - Auriculer conchal cartilage - Use of auricular conchal cartilage in nose aesthetic surgery


After the cartilage graft has been removed from the auricle, applying the antibiotic cream or pomades to the suture area in the incision area, water contact should be avoided for up to 2 weeks. The cartilage can be retracted after the 1st week on the received auricle. It is appropriate not to enter the pool before the wound is fully healed. The sutures which are meltable in the back of the auricle usually fall within 2-3 weeks.
 

Does the shape of the auricle change after the cartilage graft taken from the auricle? 

Auricular Cartilage (Auricular Cartilage) Graft in Revision Rhinoplasty - Why auricle cartilage graft is needed in revision rhinoplasty operations? - When auricle cartilage graft is used in revision nose job surgeries? - How to taken the cartilage graft from the auricle (auricular conchal cartilage)? - Recommendations after the cartilage graft taken from the auricle  - Does the shape of the auricle change after the cartilage graft taken from the auricle? - Why is a cartilage graft removed from the auricle? - In which cases is the cartilage graft used from the auricle? - Use of cartilage graft taken from the ear for revision nose aesthetic - Cartilage graft taken from the auricle - What to do after taken of the cartilage graft from the auricle? - Auriculer conchal cartilage - Use of auricular conchal cartilage in nose aesthetic surgery
 
 
While the cartilage graft is removed from the auricle, cartilage areas that are responsible for the folds of the auricle and the needles of cartilaginous glands are usually marked with needles. Generally, when conchal cartilage is performed by making an incision on the back of the bucket; When seen from the front, it is quite difficult to understand that cartilage tissue is removed. Usually an exaggerated color change and bruising is not seen. There may be different techniques and different techniques applied by physicians. Therefore, it is best to pay attention to the recommendations of your own doctor after the procedure.
 

 
 
 
 
 
 

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47



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