KAREN H.CALHOUNMDRONALD B.KUPPERSMITHMDNot Available
Dr Parker Porter thoroughly reviews the pros and cons of using alloplastic and autogenous implants in the nose. Porter discusses the many articles that report a positive experience with autogenous materials such as septal, auricular, and costal cartilage. She points out that problems associated with the use of autogenous materials are frequently a result of surgeon error.1 I have had similar experiences and note that when a problem occurs with autogenous cartilage grafting, it is frequently because of surgeon error. Such errors include inadequate sculpting of the cartilage graft, an asymmetric or overly large pocket for the graft, or a poorly sized or shaped graft. If the pocket is too large, then the cartilage graft can become displaced more readily. When using autogenous cartilage grafts, the surgeon must spend more time dissecting the pocket and precisely sculpting the graft. One of the advantages of using alloplasts (not mentioned in Dr Porter's review) is the ease of use. There is much less time spent in preparation of the pocket and sculpting the implant.
Toriumi DM. Autogenous Grafts Are Worth the Extra Time. Arch Otolaryngol Head Neck Surg. 2000;126(4):562-564. doi:10.1001/archotol.126.4.562