Perichondrial Attached Diced Cartilage (PADC), a Novel Graft Material for Nasal Augmentation: 10 Years of Experience.

Abstract

Achieving dorsal augmentation with onlay grafts presents several challenges. Visibility and warping of grafted cartilages can ruin an otherwise successful operation. A shortage of septal cartilage and rib donor site morbidity compound the problems associated with this procedure. The aim of this study was to find an autologous material for dorsal nasal augmentation that does not disperse upon implementation. This material also should have minimal resorption, resist warping, and not require a wrapping membrane. In 30 patients, concha cartilage of the ear with attached perichondrium and fascia were removed. The concha cartilage was diced while it was attached to the posterior soft tissue. The purpose was to develop graft material for dorsal augmentation. In an average of 19.56 months follow-up, no sign of resorption, infection, inflammation, volume loss, or displacement of the grafted material was observed. Aesthetically the results were acceptable and most of the patients were satisfied with the outcome. Perichondrial attached diced cartilage is a new material for the rhinoplasty surgeon to apply in different onlay nasal augmentation procedures in the unduly reduced nasal dorsum. This technique transforms uneven, peculiarly shaped concha cartilage into a flexible, versatile, and durable material. The donor site is in the surgical field and easy to access.