Split calvarial bone graft for chemical burn-associated nasal augmentation.

ABSTRACT

The nose is the central part of the face, and constitutes the most prominent projection in facial geometry. This report presents five cases that sustained a chemical burn injury with associated facial mutilation resulting from contact with strong acids. The chemical burn affected the nasal architecture after inflicting a burn injury to the face. Applying bone deriving from a split skull procedure for the nasal projection restoration and the augmentation of the dorsal nose is a feasible undertaking, and the overall result appears satisfactory. A retrospective survey of cases admitted to our clinic from January 1999 to December 2001, inclusively was undertaken and is described below. Split calvarial bone graft procedure for the nasal tip projection reconstruction was performed for five patients, all of whom had sustained chemical burns following assault by strong acid. The disfiguration of the nasal anatomical structure was due to healing from deep burn wounds. The tip became blunt and less protruberant following the arising of cicatricial tightness of the surrounding tissue. Strength and resistance to scar contraction are the first considerations for such implantation when attempting to correct the nasal tip projection. The five female patients sustained a severe chemical burn which involved a surface area ranging from 25 to 60% of total body surface area. The facial mutilation was noted simultaneously with the determination of the extent of the burning injury. A severe burn scar is the typical sequel following a deep chemical burn. Nasal tip projection was restored and a nasal dorsum augmentation procedure with a split calvarial bone graft under an "open" method was used. This particular surgical procedure was able to be used in order to improve the nasal tip projection and resist surrounding scar contracture. The three-dimensional surface structure of the face became more prominent subsequent to the administration of this procedure.