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Free Cartilage Grafts in Facial Reconstruction: Literature Review

Tobias Long, MD Jeremy Bordeaux, MD
University Hospitals Cleveland, OH
2013-02-28

Presenter: Tobias Long, MD

Affidavit:
The above work is all original work by resident.

Director Name: Bahman Guyuron

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics

Introduction: Cartilage grafts are sometimes used during facial reconstruction. Cartilage grafts may be used alone or in addition to either local skin flaps or interpolation flaps. Indications for cartilage graft use, donor sites for cartilage grafts, harvesting techniques for cartilage grafts, and outcomes following cartilage graft use are varied.

Methods: Pubmed and Medline were searched (1958 to 2013) using "cartilage graft AND facial reconstruction". When available, the following information was obtained: Indication for cartilage graft use, location of cartilage graft use, what flap (if any) was used in addition to the cartilage graft, location that the cartilage graft was harvested from, technique of cartilage graft harvest, how the cartilage graft was secured to the recipient site, wound care, post-operative results and patient satisfaction.

Results: The search returned 438 articles for review. Cartilage grafts were most frequently used to restore the three dimensional shape and prevent free margin distortion. They were most frequently used on the nose (especially the ala) and ear. Cartilage grafts were frequently used in addition to paramedian forehead flaps, cheek to nose interpolation flaps, and retroauricular interpolation flaps. Cartilage was harvested from the conchal bowl, antihelix, and nasal septum. Harvesting techniques and wound care varied. Post-operative results were generally positive.

Discussion: This article provides the surgeon with a review of cartilage graft use in facial reconstruction.

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