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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Jaypee Brothers Medical Publisher
2025-06-01
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| 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 |
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| 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. |
| format | Article |
| id | doaj-art-279f86f5459d450cb2b90e18d8faef15 |
| institution | Kabale University |
| issn | 2277-8969 2278-0262 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Jaypee Brothers Medical Publisher |
| record_format | Article |
| series | Journal of Postgraduate Medicine, Education and Research |
| 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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