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Rhinoplasty in the treatment of traumatic nasal deformity remains one of the most challenging problems for surgeons. Reconstruction of the nasal osseocartilaginous framework is the foundation of successful rhinoplasty. In this article, we present our experience in restoration of the dorsum of the nose in post-traumatic nasal deformities, by carved insitu split costochondral graft as a new technique to restore the missing part of the nose. Patients and Methods: From April 2013 to May 2016, 13 patients, including nine males and four females underwent augmentation rhinoplasty for the correction of the posttraumatic nasal deformity. Patients in need of soft tissue reconstruction were excluded from this study. The nature of nasal deformities varied between saddle nose, a crooked nose or combined. The nasal dorsum was restored using the split costochondral graft. The mean follow-up period after the surgery was 22 months. Patients’ satisfaction evaluation was obtained, and the results were analyzed and reported. Results: A total of 13 rib graft rhinoplasties were performed in the three-year review period. The mean duration of clinical follow-up was 22 months. None of the grafts warped. None of the patients had lost dorsal projection; only one patient has lost the columellar strut secondary to infection, two of the patients developed hypertrophic scars, and two of 13 patients (26%) had revision surgery for minor cosmetic revision. Conclusion: The fundamental strength of the osseocartilaginous rib graft lies in replacing like with like. In-situ splitting of the costochondral graft provides a safe and efficient method to restore the nasal dorsum. A chimeric bony and cartilaginous graft allows for bone integration with the nasal dorsum, preventing mobilization, and allows for subtle sculpting of the cartilaginous nasal tip.

Abstract 16.25 THE ROLE OF SPLIT COSTOCHONDRAL GRAFT IN THE RESTORATION OF NASAL DORSUM IN POST-TRAUMATIC NASAL DEFORMITIES