• JAMA Facial Plast Surg · May 2013

    The oblique split method: a novel technique for carving costal cartilage grafts.

    • Eren Taştan, Ömer Taşkın Yücel, Emine Aydin, Filiz Aydoğan, Kaan Beriat, and Mustafa Gürhan Ulusoy.
    • Ministry of Health Ankara Training and Research Hospital, Ulucanlar Caddesi, Altindag/Ankara, Turkey 06630. drerentastan@gmail.com
    • JAMA Facial Plast Surg. 2013 May 1; 15 (3): 198-203.

    ImportanceAutogenous rib cartilage is widely used in the septorhinoplasty cases with major structural grafting requirements. However, there is a risk of warping over time.ObjectiveTo introduce a novel method for carving costal cartilage grafts to obtain straight grafts of varying thicknesses and to eliminate the risk of warping.DesignBetween 2007 and 2011, a total of 43 consecutive patients underwent septorhinoplasty using autogenous costal cartilage grafts carved by the oblique split method (OSM).SettingThe Ankara Training and Research Referral Hospital, Ankara, Turkey.ParticipantsThe study included 43 patients with saddle nose deformity and revisional rhinoplasty with a depleted source. All patients were followed-up for a period ranging from 12 to 37 months (mean, 19.2 months) after surgery.InterventionsAll patients underwent open or closed septorhinoplasty. Autogenous costal cartilage was carved with the OSM to obtain grafts suitable for use as columellar strut, dorsal onlay, L-strut, lateral crural strut, caudal extension, and tip or speader grafts in selected cases.Main Outcome MeasuresPatients were evaluated by inspection, palpation, and photographic documentation before surgery. Inspection, palpation, and photographic documentation were carried out every 6 months and 12 months after surgery and once a year thereafter.ResultsPatient satisfaction in terms of form and function was achieved in 41 patients (95%). Two patients required reoperation for further tip projection (n=1) and alar batten graft displacement (n=1). No complication was observed as a result of graft warping, resorption, or fracture.Conclusions And RelevanceThe OSM provides straight costal cartilage grafts of varying thicknesses without the risk of warping. Because they strictly preserve their straight form, the grafts may safely be modified into rectangular shape or carved asymmetrically and/or have their edges beveled. Current data from this study suggest that the OSM offers a flexible and reliable reconstructive option for the rhinoplasty surgeon.Level Of Evidence4.

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