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June 1995

The Use of Calvarial Bone in Nasal Reconstruction

Author Affiliations

From the Department of Otolaryngology, Division of Facial Plastic and Reconstructive Surgery, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Mass.

Arch Otolaryngol Head Neck Surg. 1995;121(6):643-648. doi:10.1001/archotol.1995.01890060041008

Objective:  To demonstrate the utility of calvarial bone as a primary graft choice in nasal reconstruction.

Design:  Case series.

Setting:  Academic tertiary care center.

Pattern:  Thirty-five consecutive patients who underwent split calvarial bone grafting to the nasal dorsum between June 1988 and September 1993 and who had postoperative follow-up.

Outcome Measures:  Serial clinical examination to assess volume loss, movement of the graft, and complications. Standardized photographs to assess nasal contour.

Results:  Fixation of the graft was accomplished using a technique that promotes bone-to-bone healing without fixation screws or wires. The most common complication was seroma or hematoma of the scalp (8%). There were no dural tears or intracranial complications. Longterm donor site morbidity consisted of one case of local alopecia (2.8%). A good nasal contour was achieved in 97% of patients.

Conclusion:  Based on the experimental evidence reviewed and our clinical experience, split calvarial bone is recommended as a material of choice for nasal dorsal reconstruction.(Arch Otolaryngol Head Neck Surg. 1995;121:643-648)

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