Anatomical characteristics of the conchal cartilage with suggested clinical applications in rhinoplasty surgery.

BACKGROUND

Numerous cartilage grafts from a number of donor sites have been described, each with a different shape and size. These donor sites include the nasal septum, costal chondral cartilage, and the conchal bowl. Although harvests from the conchal bowl are commonly-employed, the techniques have been minimally-described in the literature, particularly as it applies to rhinoplasty.

OBJECTIVES

The authors identify differences in the conchal bowl cartilage parameters that could aid in the planning and harvesting of conchal grafts during augmentation rhinoplasty.

METHODS

The authors dissected ears from fourteen cadavers (eight females and six males), ranging between 59 and 77 years of age. The conchal bowls were isolated, after which a reference point or was marked at the junction of the helical root and the conchal extension of the helical root. A cartilage grid was mapped out at 3-mm interval divisions with a horizontal limb axis parallel to the helical root extension and a vertical limb axis perpendicular to the latter. Conchal cartilage width, height, and thickness were then measured. Axial tissue slices were harvested and histologic preparations completed with hemotoxylin and eosin (H&E) staining to delineate microscopic characteristics of the cartilage.

RESULTS

Maximum conchal bowl width ranged from 1.9 to 2.9 cm and was widest on average over the cymba (2.4 ± 0.3 cm). Maximum conchal bowl height ranged from 1.7 to 3.1 cm and was greatest on average over the region posterior to the junction of the helical root and conchal bowl (2.4 ± 0.5 cm). Conchal bowl thickness ranged from 1.9 to 4.4 mm and was observed thickest over both the conchal extension of the helical root (3.5 ± 0.4 mm) as well as over a distinct region in the inferior-anterior aspect of the cavum (3.7 ± 0.9 mm). No difference in thickness was observed between the conchal extension of the helical root (3.5 ± 0.4 mm) and the distinct region in the inferioranterior aspect of the cavum (3.7 ± 0.9 mm; P > .05). Naturally-occurring cartilaginous divisions were appreciated on histologic specimens located at the junction of the cavum and external auditory meatus and at the junction of the helical root and conchal extension of the helical root.

CONCLUSIONS

The results, examination, and outline of conchal bowl parameters from cadaver cartilage demonstrated in this article will aid the surgeon in effectively obtaining the appropriate cartilage grafts for placement during rhinoplasty.