Reconstruction of Internal Nasal Valve, Septum, Dorsum, and Anterior Structures of the Nose in a Single Procedure With a Molded Bone Graft: The Sail Graft

Abstract

Excessive surgical removal or traumatic loss of the tissues supporting the nasal roof can result in the -saddle nose- deformity. It involves both cartilage and bone deficiencies. Two main resources are used to reconstruct this difficult deformity: autogenous bone and cartilage grafts and alloplastic materials. This study presents the reconstruction of the dorsum, septum, internal nasal valve, and anterior structures and the tip of the nose using a block of molded autogenous bone graft. We called it the -sail graft,- because it looks like a sail from a lateral view. The mast of the sail is oriented in a superior-to-inferior direction, beginning in the frontonasal region to the tip of the nose to form a straight, well-rounded dorsum. The longest postoperative follow-up of 13 cases is now 10 years; the median follow-up is 2 years. The results have been satisfactory.