Sphenoidal process of septal cartilage: Useful autologous graft option in revision rhinoplasty

Abstract

Background: One of the main difficulties of revision rhinoplasty is the lack of sufficient septal cartilage. To overcome this problem, additional cartilage sources such as costal or conchal cartilages are widely used among surgeons. However, these methods can cause some complications. The sphenoidal process of septal cartilage (SPSC) is a unique part of septal cartilage located between the vomer bone and the perpendicular plate of the ethmoid bone and generally untouched during the surgery. As an autologous graft option, the SPSC may be an important cartilage source for revision rhinoplasty cases, especially in patients requiring minor surgical intervention. Methods: Between February 2019 and February 2020, a total of 50 patients who underwent paranasal computed tomography were enrolled in this retrospective study. The length, height, and surface area of the SPSC and surface area of total septal cartilage were calculated. Results: The mean total septal area was 886.2 mm2, ranging from 554.7 mm2 to 1277.5 mm2. The mean total SPSC area was 67.39 mm2. The mean length of SPSC was 12.8 mm in all populations. The highest sphenoidal process length measurement was 27.32 mm, and the lowest was 4.82. Mean sphenoidal process height values were similar in female and male groups (4.99 mm and 5.2 mm, respectively). Conclusion: The sphenoid process of septal cartilage may be an important autologous cartilage option for revision surgeries in terms of sufficient length and height dimensions.