Rhinoplasty: Q&A

Ask a Question

Use of Ethmoid Bone Grafts in Rhinoplasty

I am considering Rhinoplasty in Missouri. I have met with a few ENT physicians and a few things have come up. I have a severely deviated septum. One is considering ethmoid bone grafts.

If done, the surgery would take five hours. Is this routine? It doesn't seem normal. I do I believe he specializes in revisions. What is the indication for ethmoid bone grafts? What are they for? When are they used in rhinoplasty? Also, why do some surgeons use internal splints and others do not?

Updated: 11/23/09

I wanted to thank EVERY DOCTOR who submitted a response to my question about ethmoid bone grafts. It was such an immense help and really made me narrow down who I choose to do my surgery. You all are the ones who make this a fantastic place for patients to come to.

Tags:

Comment on this

17 Doctor Answers | Asked by sharma80 in Toledo

Doctor Answers (17)
Community Comments (0)

Bone grafts and revision rhinoplasty

The problem with bone grafts is that they are not as dependable an alternative as cartilage grafts. Large surgical case series show that cartilage grafting in the nose produces long lasting dependable results. I think you can tell this from the consensus of opinions among the other surgeons. I also agree that 5 hours is likely too long as far as operative time is concerned even for revision surgery.

Rhinoplasty and Deviated Septum

Hi Sharma, I have never heard of ethmoid bone grafts. Maybe your surgeon is referring to the ethmoid bone plate which is an extension of your cartilagenous septum in the rear of your nose?? Severely deviated septums may require spreader grafts but cartilage is typically used for this. 5 hours is a very long time for any kind of rhinoplasty. Even revision rhinoplasties or very complex rhinoplasties should not take more that 3 hours tops for an experienced rhinoplasty surgeon. Maybe you... more

Ethmoid bone grafts in rhinoplasty

Ethmoid bone is sometimes taken with septal grafts if there is not enough septum to work with. Usually there is enought septum for most grafting. A five hour rhinoplasty is extremely unusual.

Steven Wallach, MD

13 reviews

Manhattan Plastic Surgeon

You might also like...

Real Stories

Definitely Worth It! - Vancouver, BC

I've always wanted to have rhinoplasty ever since I was a little girl. My nose is the...

Before + After Photos

View 3573 Rhinoplasty photos

Rhinoplasty and septal deviation

It would be unfair to make judgment about the time to repair your nose without seeing for myself how problematic your nose is. That said, 5 hours for a primary septorhinoplasty seems to be a bit excessive. Ethmoid bone grafts are used for rhinoplasty and for revision rhinoplasty, however, in primary rhinoplasty you should have ample cartilagenous septum to work with which is easy to harvest and very satisfying to work with. Removing portions of the ethmoid bone during septoplasty is... more

Philip S. Schoenfeld, MD

1 review

Chevy Chase Facial Plastic Surgeon

Seriously deviated septum

Dear Sharma, Please read the answer I just submitted regarding my own septoplasty experience. I went to Dallas from Seattle to Dr. Gunter and Dr. Cochran, his partner and had a perfect result. If you are not totally set on staying where you are, you might consider this too. It is listed under "Recommendations for revision rhinoplasty surgeons in Texas."

Ethmoid bone grafts in rhinoplasty

Septal cartilage, not ethmoid bone is the primary choice for grafting in the nose. The posterior portion of the nose is ethmoid bone, which is very thin and does not add much structural contour to the nose. Five hours seems an excessively long period of time to undergo a rhinoplasty. Internal splints are no longer used in rhinoplasty and/or septoplasty because they have not been proven to be of any benefit.

Bone Grafts in Rhinoplasty Surgery

Although bone grafts were frequently used in years past, most rhinoplasty surgeons today feel that cartilage grafts are much more reliable. The use of internal splints is individualized depending on the needs of each patient and the surgical techniques performed.

Richard W. Fleming, MD

10 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Ethmoid Bone Grafts

Hello, I prefer not to use Ethmoid bone grafts. I only use cartilage to straighten septum. Generally to straighten a septum, you don’t need grafts, just a well performed septoplasty. Sometimes, you may use spreader grafts. I use silicone splints following a septoplasty, and they will remain in the nose for one week following placement. Hope this helps answer your question. Dr. Nassif

Ethmoid bone grafts for rhinoplasty/septoplasty

They are rarely used, and seem to be a last resort if nothing else is available. If the septum is severely deviated, then it is destabilized as part of the mobilization to allow it to return to midline. To keep the reconstruction straight, a plate of additional cartilage is often used as a strut or brace as it is secured to the unstable and straightened segment. Just like a casted broken arm. Depending on where they are placedand what additional function they may provide, these struts... more

Drastic times call for drastic measures. rhinoplasty, septal deviation and bone grafts

You may want to clarify this point with your plastic surgeon. As you can see from the comments below. this is not a conventional approach but you may not have a conventional nose. As we say, drastic times calll for drastic measures, and this may be so for your nose.

Doctors will not see your comments on their answers. If you'd like to follow up, please go here to ask another question.

Comments (0)

Ask a Question

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.