[2004.03.27] Usefulness of Vomer & Ethmoid Grafts in Rhinoplasty

Date: March 27, 2004
Conference: 22nd Meeting of the Korean Academy of Aesthetic Plastic Surgery (Shilla Hotel)
Title: The Usefulness of Vomer & Ethmoid Grafts in Rhinoplasty

Background

As rhinoplasty advances from methods relying primarily on implants to those emphasizing anatomical structure, septal cartilage has become increasingly recognized for its crucial role. Within the nasal cavity, the anterior septum is composed of cartilage, while the posterior segment consists of the vomer and the perpendicular plate of the ethmoid. However, because each individual’s nasal septum features a different ratio of cartilage to bone, surgeons may encounter difficulty obtaining an adequate amount of septal cartilage for supporting and shaping the nose.

Methods

To address cases where the septal cartilage is insufficient in volume or too weak to provide reliable buttressing, the authors harvested sections of the vomer and ethmoid bones while preserving the L-shaped strut of the septum. Thin bony plates acquired from the vomer and ethmoid have shown considerable strength, making them exceptionally useful for providing support in rhinoplasty. Despite their utility, no reports on their clinical application had been published domestically prior to this study.

From August 2001 to January 2004, the authors applied vomer and ethmoid bone grafts in 47 cases. Indications included reinforcing weakened or curved septal cartilage via spreader grafts, supporting the septal angle, batten grafting the distal septum, placing extended spreader grafts, augmenting the dorsal-radix area, and using lateral batten grafts.

Results

In all 47 cases, vomer and ethmoid grafts effectively reconstructed and stabilized nasal structures without complications. The ability to harvest thin but strong bony plates made these grafts highly useful for both primary reinforcement and partial grafting procedures.

Conclusion

Vomer and ethmoid bone grafts offer a valuable solution for patients with insufficient or compromised septal cartilage. Their rigidity and shape make them particularly helpful for structural support in rhinoplasty. The authors report positive clinical outcomes and no significant complications, suggesting that these grafting techniques may be a beneficial addition to the rhinoplasty toolkit.