Rib Cartilage Grafts - Stablized with Threaded K-Wire? (photo)

We have seen extrusion of K wires come out through the nose from a rib cartilage graft. Best to use nasal cartilage first before attempting to use rib cartilage

The idea behind this, as you alluded to, is to stabilize and secure the somewhat unpredictable nature of rib cartilage with a rigid K wire. I've never used this technique but am aware of surgeons who do often. Concentric carving and patience will usually reveal the tendency of the rib cartilage to warp. Typically this gives enough information to reveal which pieces of cartilage should be used and how they should be positioned. Silastic implants do play a role but are used far more frequently in Asia.Stephen Weber MD, FACS

I have not heard of using K-wires to stabilize dorsal rib only grafts. One would expect that it would decrease the known resorption rate of these grafts, but add small risks of infection and extrusion. I find with saddle noses that structurally rebuilding the deficient dorsal septal strut and pulling up the upper lateral cartilages to the higher strut is a more permanent solution and also will improve the airway. Ethnic noses I use layered Gortex.