الفهرس 
AESTHETIC ANATOMY OF THE NOSEOnly 14 pages are availabe for public view
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Abstract
Rhinoplasty may require the addition of material to augment the nose for both aesthetic and functional indications. Functional reasons for augmentation include providing structural support for areas deficient of material, such as the upper or lower lateral cartilages. Augmentation also may be required for aesthetic reasons to increase the projection of the nasal dorsum on the profile view or to augment the nasal tip. In addition, grafts may be placed to camouflage irregularities of the bony dorsum and /or of the upper or lower lateral cartilages.
The use of autologous cartilage grafting has been demonstrated to be effective in improving both the functional and cosmetic aspects of the nasal framework. Cartilage is easily manipulated and can be used to provide firm support and contouring.
Use of diced cartilage grafts in rhinoplasty surgery has recently undergone a dramatic resurgence. However, it was Erol’s “Turkish delight” modification of diced cartilage grafting for dorsal nasal augmentation that has recently popularized its use.
Our work aimed to assess the usage of Surgicel-wrapped diced cartilage in augmentation of the nose versus classic cartilage technique and evaluate the efficiency of this new technique versus the classic one.
To reach our aim, thirty adult patients of both sexes requiring rhinoplasty operation for dorsal augmentation were enrolled in this study. Patients were classified into two groups, fifteen patients each.
Patients of the first group had dorsal augmentation with Surgicel-wrapped diced cartilage technique. Patients of the second group had dorsal augmentation with classic cartilage technique.
As regards the effect of augmentation materials on the aesthetic results of patients’ photography, the parameters studied in lateral view in our study were: nasofrontal angle, nasofacial angle, radix projection, dorsal projection at rhinion, mid dorsal projection and tip projection.
In addition these parameters, MRI was done for some selected cases to evaluate the rate of resorption in both grafts at 1 month and 6 months.
We found that dorsal augmentation with both grafts had a statistically significant effect on nasofrontal angle, nasofacial angle, dorsal projection at rhinion, mid dorsal projection and tip projection by changing their measurements toward the normal range; yet concerning these latter mentioned parameters the difference between the first (Surgicel-wrapped diced cartilage) and the second group (Classic cartilage technique) was not statistically significant.
According to the degree of resorption, Surgicel-wrapped diced cartilage grafts maintained approximately 85% to 90% of their dimensions in MRI. While the Classic cartilage technique grafts maintained approximately 90% to 95% of their dimensions in MRI. This suggested that the degree of resorption was present in both types of grafts, but it was higher in Surgicel diced cartilage grafts but the grafts maintained approximately most of its thickness after 6 months.
At the end we conclude that the advantages of surgicel diced cartilage graft technique ‘Turkish Delight’ are:
• Its ease of preparation
• Increase the volume of graft available for use
• Avoidance of contour irregularities
• This technique shortens the operative time significantly by eliminating graft harvest and avoids donor site morbidity
• This technique is effective for dorsal nasal augmentation