Congenital, posttraumatic, or postrhinoplasty saddle nose deformity is a mandatory issue for plastic surgeons and reconstruction is based on the use of supportive grafts to manage aesthetic and functional problems.
Graft can be attained from bone (calvarial,iliac crest,costal,nasal hump,ulnar and heterogenous origin), cartilage (septal,costal,heterogenous) and synthetic materials (silicone,rubber,acrylic,ivory,polyethylene,Gore-tex,silastic) used as support grafts.
The aim of this study is whether DBM(demineralized bone matrix) may reconstruct aesthetic and functional problems in saddle nose deformity.Best of our knowledge this is the first publication using DBM in saddle nose deformity.
Methods/Technique:
Total of 48 patients with saddle nose deformity cause to posttraumatic and postrhinoplasty who underwent reconstructive surgery between 2005-2007.An open rhinoplasty performed. DBM was covered with oxidized cellulose, placing dorsum of the nose and tip plasty applied. Suture packings and nasal splint applied. Antibiotherapy given for 5 days
Results/Complications:
There were no complications related to DBM or technique seen 2 years following.Adequate support to be gained after early and late postoperative period
Conclusion:
Saddle nose separated three groups depends degree of deformity: minor,intermediate,major. Lots of nominal surgical options such as septal cartilage correction,flying wing operation and supportive bone, cartilage grafts and synthetic materials
DBM comprise %93 collagen, %5 noncollagen proteins(bone morphogenic protein,insulin like growth factor,platelet derived growth factor,fibroblast growth factor) and %2 residual mineralized matrix.DBM have osteoinduction and osteoconduction potential.DBM can be shaped and induce bone formation when placed skeletal muscle and subcutaneous tissue.
All procedures have potential complications like infectious,collapse,late resorption,extrusion, insufficient restoration.Choosing the most suitable material for nasal reconstruction is difficult.Most studies suggest one substance over another, therefore surgeon’s experience and preference play significant role in success of surgery.
DBM is a reliable material for saddle nose deformity reconstruction that eliminates need for second operative site to harvest bone graft and prevent accordingly complications