J Korean Assoc Oral Maxillofac Surg.  2023 Oct;49(5):270-277. 10.5125/jkaoms.2023.49.5.270.

Donor site morbidities of concha cartilage harvesting using a retroauricular approach for cleft rhinoplasty: retrospective study

• Themkumkwun S
• Vorakulpipat C
• Boonsiriseth K

• KMID: 2547571
• DOI: http://doi.org/10.5125/jkaoms.2023.49.5.270

Abstract

Objectives
Concha cartilage is recommended for correction of cleft nasal deformities. Morbidities at the donor site have been reported in esthetic rhinoplasty cases. Reports on cleft patients are limited, so we investigated the complications of concha cartilage harvesting using the retroauricular approach in cleft rhinoplasty and their management.
Materials and Methods
This was a retrospective review of the charts of 63 patients with cleft deformities who underwent septorhinoplasty with concha cartilage. All cases were harvested using a retroauricular approach. Data on patient demographics, surgery type, amount of cartilage harvested, and complications were gathered.
Results
Sixty-three patients were enrolled (21 males and 42 females). The mean age of patients was 20.2±5.9 years. Complications were observed in 6 cases (9.5%) and included delayed wound healing (4.8%), prolonged postoperative pain (1.6%), postoperative paresthesia (1.6%), and prominauris (1.6%).
Conclusion
The rate of complications associated with concha cartilage harvesting using a retroauricular approach is low. The use of meticulous surgical techniques, especially hemostasis control and adequate wound dressing, is key to minimizing postoperative complications.

Keyword

Congenital abnormalities; Rhinoplasty; Ear; Methods; Surgery

Figure

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  Fig. 1 Surgical procedure of concha cartilage harvesting by using retroauricular approach. A. An incision was made in a curved fashion. B. Subperichondrial dissection was done at the posterior surface of the concha cartilage. C, D. Short gauge 30 hypodermic needles were used to set boundaries of the harvesting area. E. Hemostasis was done. F. Bolster gauze dressing. G. The subcuticular suture was performed with an inserted Penrose drain. H. The harvested concha cartilage.

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  Fig. 2 The patient with dehiscence wound. A. Dehiscence wound size 5 mm. B. The wound was resutured in a simple interrupted manner. C. Two weeks after resuturing, the wound was healed.

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  Fig. 3 The patient with left ear prominauris.

Reference

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