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March 1995

Management of the Nasal Dorsum in Central Facial Injuries: Indications for Calvarial Bone Grafting

Author Affiliations

From the Department of Otolaryngology—Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, The Johns Hopkins Medical Institutions, Baltimore, Md.

Arch Otolaryngol Head Neck Surg. 1995;121(3):307-312. doi:10.1001/archotol.1995.01890030045007

Objective:  To demonstrate criteria for primary calvarial bone grafting in central facial fractures.

Design:  Retrospective, cohort study.

Setting:  University of Iowa Hospitals and Clinics (Iowa City) and The Johns Hopkins Hospital (Baltimore, Md).

Patients:  Consecutive sample of 27 patients with nasoethmoidal fractures.

Intervention:  Preoperative and intraoperative analysis with surgical intervention. Patients with the following criterion received primal dorsal calvarial bone grafts: loss of dorsal nasal support in the upper bony and lower cartilaginous dorsum.

Main Outcome Measure:  Prevention of cicatricial softtissue contraction of the nose with primary bony dorsal reconstruction and/or nasal bone grafting.

Conclusion:  In certain severe cases of nasal bony and cartilaginous comminution, primary dorsal nasal calvarial bone grafts are indicated.(Arch Otolaryngol Head Neck Surg. 1995;121:307-312)