Double Chondrocutaneous Composite Free Graft in Nasal Reconstruction. Report of a Case and Technique Description

Luigi Maria Lapalorcia, Fabio Massimo Abenavoli, Marino Cordellini

.

DOI: 10.4236/ss.2011.210105                

Abstract

Full thickness skin grafts and composite grafts are a workhorse in reconstructive surgery of nose and ear defects whether they are originated from trauma, cancer surgery or burns. The reliability of these grafts has been proved with an established clinical use and morbidity to the donor site is minimal if harvesting and donor site selection if appropriate. Use of double or multiple grafts to reconstruct a complex defect of the nose has not been described and our report is meaningful for the fact that it describes a further use of the surgical concept of grafting.

Keywords

Nasal Reconstruction, Composite Graft, Free Chondrocutaneous Graft, Skin Graft, Burns, Cartilage Graft, Donor Site

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Y. K. Coban and Y. Geyik, “An Ideal Composite Graft Donor Site for Postburn Alar Rim Deficiencies: Root of Helix,” Journal of Craniofacial Surgery, Vol. 21, No. 4, 2010, p. 1246. doi:10.1097/SCS.0b013e3181e431f4
[2]	P. D. McCluskey, F. C. Constantine and J. F. Thornton, “Lower Third Nasal Reconstruction: When Is Skin Grafting an Appropriate Option?” Plastic & Reconstructive Surgery, Vol. 124, No. 3, 2009, pp. 826-835. doi:10.1097/PRS.0b013e3181b03749
[3]	S. Riml, H. Wallner, L. Larcher, U. Amann and P. Kompatscher, “Aesthetic Improvements of Skin Grafts in Nasal Tip Reconstruction,” Aesthetic Plastic Surgery, Vol. 25, No. 4, 2010, pp. 475-479.
[4]	S. Kobayashi, U. Haramoto and K. Ohmori, “Correction of the Hypoplastic Nasal Ala Using an Auricular Composite Graft,” Annals of Plastic Surgery, Vol. 37, No. 5, 1996, pp. 490-494. doi:10.1097/00000637-199611000-00006
[5]	L. Ohlsén, “Closure of Nasal Septal Perforation with a Cutaneous Flap and a Perichondrocutaneous Graft,” Annals of Plastic Surgery, Vol. 21, No. 3, 1988, pp. 276-288. doi:10.1097/00000637-198809000-00017
[6]	J. M. Avelar, J. M. Psillakis and F. Viterbo, “Use of Large Composite Grafts in the Reconstruction of Deformities of the Nose and Ear,” British Journal of Plastic Surgery, Vol. 37, No. 1, pp. 55-60. doi:10.1016/0007-1226(84)90043-2
[7]	S. H. Lipman and R. J. Roth, “Composite Grafts from Ear Lobes for Reconstruction of Defects in Noses,” Journal of Dermatologic Surgery & Oncology, Vol. 8, No. 2, 1982, pp. 135-137.
[8]	D. F. Kalbermatten, M. Haug, R. Wettstein, D. J. Schaefer and Pierer G. “New Posterior Auricular Perichondrial Cutaneous Graft for Stable Reconstruction of Nasal Defects,” Aesthetic Plastic Surgery, Vol. 29, No. 6, 2005, pp. 489-495. doi:10.1007/s00266-005-0069-1
[9]	M. D. Haug, U. M. Rieger, P. Witt and W. Gubisch, “Managing the Ear as a Donor Site for Composite Graft in Nasal Reconstruction: Update on Technical Refinements and Donor Site Morbidity in 110 Cases,” Annals of Plastic Surgery, Vol. 63, No. 2, 2009, pp. 171-175. doi:10.1097/SAP.0b013e318189a9c4
[10]	D. J. Singh and S. P. Bartlett, “Aesthetic Management of the Ear as a Donor Site,” Plastic & Reconstructive Surgery, Vol. 120, No. 4, 2007, pp. 899-908. doi:10.1097/01.prs.0000277659.88395.a5
[11]	K. Tomita, K. Hosokawa, K. Yano, A. Takada, T. Kubo and M. Kikuchi, “Dermal Vascularity of the Auricle: Implications for Novel Composite Grafts,” Journal of Plastic, Reconstructive & Aesthetic Surgery, Vol. 62, No. 12, 2009, pp. 1609-1615. doi:10.1016/j.bjps.2008.06.073
[12]	P. R. Sathyanarayana Setty, F. Misquith, Jeevandrakumar, “Plastic Repair of Loss of Ala Nasi with Composite Graft from the Ear,” Journal of the Indian Medical Association, Vol. 32, No. 5, 1959, pp. 203-204.
[13]	S. Soeda, “Composite Graft from the Earlobe to the Nose,” Keisei Geka., Vol. 10, No. 2, 1967, pp. 112-119.
[14]	J. J. Pribaz and N. Falco, “Nasal Reconstruction with Auricular Microvascular Transplant,” Annals of Plastic Surgery, Vol. 31, No. 4, 1993, pp. 289-297. doi:10.1097/00000637-199310000-00001
[15]	Y. Tanaka, S. Tajima, K. Tsujiguchi, E. Fukae and Y. Ohmiya, “Microvascular Reconstruction of Nose and Ear Defects Using Composite Auricular Free Flaps,” Annals of Plastic Surgery, Vol. 31, No. 4, 1993, pp. 298-302. doi:10.1097/00000637-199310000-00002
[16]	D. J. Bottini, P. Gentile, A. Arpino, G. Dasero and V. Cervelli, “Reconstruction of the Nasal Valve,” Journal of Craniofacial Surgery, Vol. 18, No. 3, 2007, pp. 516-519. doi:10.1097/scs.0b013e318052ff30