Improving outcomes for composite grafts in nasal reconstruction

Curr Opin Otolaryngol Head Neck Surg. 2012 Aug;20(4):267-73. doi: 10.1097/MOO.0b013e328355b1f2.


Purpose of review: Auricular composite grafting is a useful technique for the reconstruction of select nasal defects. However, unpredictable graft survival has been the primary limitation of this technique. The literature was reviewed to evaluate the effectiveness of various surgical, pharmacologic, hyperbaric, and hypothermic interventions to improve composite graft survival.

Recent findings: Although no statistically significant surgical interventions were found, several techniques appear promising. There are a number of studies demonstrating the beneficial effects of perioperative and postoperative corticosteroid administration. Other agents studied have had modest to no benefit. Hyperbaric oxygen therapy holds promise but the expense, practicality, and lack of an established optimal treatment protocol remain obstacles to routine use.

Summary: The use of corticosteroids and postoperative cooling are relatively inexpensive and effective modalities to improve auricular composite graft survival when used for nasal reconstruction. Hyperbaric oxygen therapy may have a role, but more research is needed before it is employed routinely.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Animals
  • Cartilage / transplantation*
  • Disease Models, Animal
  • Graft Survival / drug effects
  • Graft Survival / physiology
  • Humans
  • Hyperbaric Oxygenation
  • Hypothermia, Induced
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Preoperative Care / methods
  • Rhinoplasty / methods*
  • Skin Transplantation / methods*
  • Subcutaneous Tissue / transplantation*
  • Tissue and Organ Harvesting / methods


  • Adrenal Cortex Hormones