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March 1991

Nasal Reconstruction With Articulated Irradiated Rib Cartilage

Arch Otolaryngol Head Neck Surg. 1991;117(3):331. doi:10.1001/archotol.1991.01870150099014

To review the article by Murakami et al1 properly, I feel that it is important to address three issues. The first concerns the effectiveness of the authors' technique in treating complex nasal saddle deformities; the second pertains to the authors' choice of implant material (irradiated homologous cartilage); and the final and, I believe, the most important issue is the need for reconstructive surgeons to report their experience with implant materials, quantifying their results, especially over the long term.

This extremely well-done retrospective review of a group of challenging cases of complex and compound nasal saddle deformity indicates a high degree of effectiveness for the surgical technique described. Successful management of this problem clearly mandates more than the usual type of reconstructive efforts that are effective in less complicated cases. The resultant complications of the authors' method of treatment are consistent with our experience in using irradiated cartilage, but could