A Comparative Analysis of Different Cartilage Grafts Used for Secondary Correction of Nasal Deformities in Cleft Lip and Palate Patients: A Case Series

Aim and background: The cleft lip nasal deformity (CLND) is characterized by numerous complex and interdependent deformities involving the soft tissues and skeleton of the nose. The underlying anatomic deformities mostly require replacement of the deficient framework with some form of cartilage graf...

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Main Authors: Ankit Aggarwal, Raja Tiwari, R Manju, Komal Gupta, Maneesh Singhal
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2025-06-01
Series:Journal of Postgraduate Medicine, Education and Research
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Online Access:https://www.jpmer.com/doi/JPMER/pdf/10.5005/jp-journals-10028-1743
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author Ankit Aggarwal
Raja Tiwari
R Manju
Komal Gupta
Maneesh Singhal
author_facet Ankit Aggarwal
Raja Tiwari
R Manju
Komal Gupta
Maneesh Singhal
author_sort Ankit Aggarwal
collection DOAJ
description Aim and background: The cleft lip nasal deformity (CLND) is characterized by numerous complex and interdependent deformities involving the soft tissues and skeleton of the nose. The underlying anatomic deformities mostly require replacement of the deficient framework with some form of cartilage grafts. With a wide array of cartilage grafts available, it becomes difficult for even the most experienced surgeon to choose the right graft for a particular patient. The primary objective of this study was to compare the properties of different cartilage grafts available for correction of secondary CLND. Methods: We present a series of 10 patients with cleft nose (all unilateral cleft) with various deformities. These patients underwent surgery between January 2018 and January 2019. Results: The follow-up period ranged from 12 to 18 months (mean: 14.7 months). Costal cartilage (<i>n</i> = 5) provided excellent long-term stability and versatility but was associated with high donor-site morbidity. Conchal cartilage (<i>n</i> = 2) offered good contouring for alar onlay grafts but showed moderate stability. Septal cartilage (<i>n</i> = 2) demonstrated minimal donor site morbidity and was ideal for smaller corrections, but limited availability constrained its use. One patient received a combination of costal and conchal cartilage, achieving excellent esthetic outcomes. Conclusion: A tailor-made approach to each deformity should be followed, where a suitable cartilage graft should be selected depending on the desired reconstructive goal. Clinical significance: These findings guide surgeons in choosing appropriate grafts based on factors such as stability, contouring ability, donor-site morbidity, and long-term results, ultimately improving surgical planning and patient satisfaction in managing CLND.
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spelling doaj-art-279f86f5459d450cb2b90e18d8faef152025-08-20T03:40:28ZengJaypee Brothers Medical PublisherJournal of Postgraduate Medicine, Education and Research2277-89692278-02622025-06-0159312412910.5005/jp-journals-10028-17433A Comparative Analysis of Different Cartilage Grafts Used for Secondary Correction of Nasal Deformities in Cleft Lip and Palate Patients: A Case SeriesAnkit Aggarwal0https://orcid.org/0009-0006-9239-4626Raja Tiwari1https://orcid.org/0000-0001-5449-3398R Manju2Komal Gupta3https://orcid.org/0000-0003-1162-7629Maneesh Singhal4https://orcid.org/0000-0001-9161-2501Department of Plastic, Reconstructive and Burns Surgery, All India Institute of Medical Sciences, New Delhi, IndiaRaja Tiwari, Department of Plastic, Reconstructive and Burns Surgery, All India Institute of Medical Sciences, New Delhi, India, Phone: +91 8882485513Department of Plastic, Reconstructive and Burns Surgery, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Plastic, Reconstructive and Burns Surgery, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Plastic, Reconstructive and Burns Surgery, All India Institute of Medical Sciences, New Delhi, IndiaAim and background: The cleft lip nasal deformity (CLND) is characterized by numerous complex and interdependent deformities involving the soft tissues and skeleton of the nose. The underlying anatomic deformities mostly require replacement of the deficient framework with some form of cartilage grafts. With a wide array of cartilage grafts available, it becomes difficult for even the most experienced surgeon to choose the right graft for a particular patient. The primary objective of this study was to compare the properties of different cartilage grafts available for correction of secondary CLND. Methods: We present a series of 10 patients with cleft nose (all unilateral cleft) with various deformities. These patients underwent surgery between January 2018 and January 2019. Results: The follow-up period ranged from 12 to 18 months (mean: 14.7 months). Costal cartilage (<i>n</i> = 5) provided excellent long-term stability and versatility but was associated with high donor-site morbidity. Conchal cartilage (<i>n</i> = 2) offered good contouring for alar onlay grafts but showed moderate stability. Septal cartilage (<i>n</i> = 2) demonstrated minimal donor site morbidity and was ideal for smaller corrections, but limited availability constrained its use. One patient received a combination of costal and conchal cartilage, achieving excellent esthetic outcomes. Conclusion: A tailor-made approach to each deformity should be followed, where a suitable cartilage graft should be selected depending on the desired reconstructive goal. Clinical significance: These findings guide surgeons in choosing appropriate grafts based on factors such as stability, contouring ability, donor-site morbidity, and long-term results, ultimately improving surgical planning and patient satisfaction in managing CLND.https://www.jpmer.com/doi/JPMER/pdf/10.5005/jp-journals-10028-1743cartilage graftscase seriescleft nosecleft rhinoplastyconchal cartilagecostal cartilageseptal cartilage
spellingShingle Ankit Aggarwal
Raja Tiwari
R Manju
Komal Gupta
Maneesh Singhal
A Comparative Analysis of Different Cartilage Grafts Used for Secondary Correction of Nasal Deformities in Cleft Lip and Palate Patients: A Case Series
Journal of Postgraduate Medicine, Education and Research
cartilage grafts
case series
cleft nose
cleft rhinoplasty
conchal cartilage
costal cartilage
septal cartilage
title A Comparative Analysis of Different Cartilage Grafts Used for Secondary Correction of Nasal Deformities in Cleft Lip and Palate Patients: A Case Series
title_full A Comparative Analysis of Different Cartilage Grafts Used for Secondary Correction of Nasal Deformities in Cleft Lip and Palate Patients: A Case Series
title_fullStr A Comparative Analysis of Different Cartilage Grafts Used for Secondary Correction of Nasal Deformities in Cleft Lip and Palate Patients: A Case Series
title_full_unstemmed A Comparative Analysis of Different Cartilage Grafts Used for Secondary Correction of Nasal Deformities in Cleft Lip and Palate Patients: A Case Series
title_short A Comparative Analysis of Different Cartilage Grafts Used for Secondary Correction of Nasal Deformities in Cleft Lip and Palate Patients: A Case Series
title_sort comparative analysis of different cartilage grafts used for secondary correction of nasal deformities in cleft lip and palate patients a case series
topic cartilage grafts
case series
cleft nose
cleft rhinoplasty
conchal cartilage
costal cartilage
septal cartilage
url https://www.jpmer.com/doi/JPMER/pdf/10.5005/jp-journals-10028-1743
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