AUGMENTATION RHINOPLASTY USING AUTOLOGOUS INFERIOR TURBINATE BONE

Abstract

BACKGROUND: Augmentation rhinoplasty is performed to correct saddle nose deformity both close
and open approaches are used for augmentation, each having its oven merits and demerits. A wide
variety of graft material i.e autologus cartilage, bone and synthetic materials are used, each having its
own advantages and disadvantages, we want to introduce a new graft material to the armamentarium,
which is easily available and not associated with a second site operating morbidity.
OBJECTIVES: To document the long-term advantages and disadvantages of inferior turbinate grafts
used to correct saddle nose deformity. Additionally, to evaluate functional improvement and cosmetic
satisfaction with the use of inferior turbinate bone as a new graft material.
MATERIAL & METHODS: it is a Retrospective chart review study conducted in Department of
Otorhinolaryngology and Head & Neck Surgery, Saidu Group of Teaching Hospitals Saidu Sharif Swat
and Hayat Medical Complex Peshawar from July 2005 to July 2013. Data was collected of all patients
who underwent closed augmentation rhinoplasty for saddle nose deformity. Data was reviewed for age
and gender of the patient, aesthetic assessment from patient as well as surgeon perspective and the
complications of the surgery. An autologous demucosalized inferior turbinate bone graft was used as a
graft material. Photo documentation were obtained before surgery, during surgery and after two weeks,
three months, six months and one year.
RESULTS: Out of 30 patients, 19 (63%) were male and 11 (37%) were female. Twenty one (70%)
were in age group 20-29, 8 (26%) in age group 30-39 & one (4%) were in age group 40 -49 years. Only
2 of the 30 patients were dissatisfied with the overall outcome. Twenty Three (77%) were extremely
satisfied, 07 (23%) were satisfied Table 03. In terms of function, ten (34%) experienced excellent relief
in nasal obstruction, 9 (30%) moderate relief, 7(24%) mild relief, and four (13%) noted no difference.
Regarding cosmesis, twenty (67%) noted excellent improvement, four (13%) moderate improvement,
four (13%) mild improvement, and two (6 %) noted no significant change. One (3%) patient reported
cyst formation at the dorsum 6 year after the operation. He was explored and managed via open
rhinoplasty approach.
The indication of augmentation rhinoplasty was nasal deformity along with nasal obstruction in 21
(70%) patients whereas 09 (30%) patients requested for cosmetic reasons only.
CONCLUSION: The inferior turbinate bone is a viable graft for augmenting saddle nose deformity.
Moreover, it maintains dorsum shape and needs little remodeling. The graft is easy to harvest, prepare,
and place and can be used without requiring a second operative site.
KEY WORDS: Saddle nose deformity, Augmentation rhinoplasty, autologous inferior turbinate graft.