Abstract
The nose is a complex, three-dimensional structure that is supported by a framework
of osseous and cartilaginous structures. Disruption of this framework can result in
nasal deformity and functional deficits. Nasal reconstruction requires restoration
of the osseous and cartilaginous framework. This requires careful preoperative assessment
of the nasal defect and understanding the nasal and facial aesthetics that are supported
by the osseous and cartilaginous support structures. Structural grafts can be classified
as restorative, supportive, or contouring. Surgeons must understand the requirements
for each type of grafting and which materials to use to provide the necessary structural
reconstruction. Autogenous, homologous, and allogenic materials can be used for reconstruction
of the structural deficits. Autogenous grafts from the septum, ear, rib, and calvarium
are preferred for structural reconstruction, but surgeons should be well versed with
alternative structural grafting materials. Smaller defects can be corrected through
cartilaginous grafts, while larger defects require more rigid bony support to withstand
the contractive forces of wound healing. Titanium mesh can serve as a viable alternative
for rigid structural reconstruction. The ultimate goal of nasal reconstruction is
to restore nasal form and function, and successful reconstruction starts with establishing
a stable, functional, and anatomically sound osseocartilaginous framework.
Keywords
nasal reconstruction - structural grafts - osseocartilaginous - bone graft - cartilage
graft
