FPS Facial Plastic Surgery · 2025

The Lateral Wall of the Inferior Meatus as a New Graft Source for Rhinoplasty: Radiological Study and Surgical Technique

Rusetsky Y, Mokoyan Z, Dutova M, Sadigov A, Balybina N, Chernova O.

What this paper says

Measuring 100 CT scans, the authors found the bone of the lateral wall beneath the lowest turbinate averages 28 by 20 millimetres and used it as a graft in four revision rhinoplasties with no complications.

Overview

Revision rhinoplasty usually needs stiff grafts to restore lost support, but most revision patients have little septal bone or cartilage left, especially after previous septoplasty, so surgeons turn to rib with its added trauma and risk. As ear, nose and throat surgeons, the authors already remove part of the lateral wall of the inferior nasal meatus during extended endoscopic access to the maxillary sinus, and proposed using it as a graft source.

Sections of note

Design: retrospective radiological study of 100 sinus CT scans, plus a small clinical series.
Average measurements of the inferior meatus lateral wall: length 28.06 millimetres, width 19.73 millimetres, thickness 0.62 millimetres.
Average deviation from the sagittal plane: 17.7 degrees.
The authors conclude the site is suitable for harvesting straight bony fragments.
The graft was used in four revision rhinoplasty cases.
No postoperative complications occurred.
Patients reported significant improvement in appearance, function and social aspects on the Rhinoplasty Outcome Evaluation.
Follow up extended up to 2 years.

What it means for a patient

This bone comes from inside the nose itself, so no chest or ear incision is needed and no new donor site is created.
It is thin, at about 0.6 millimetres, so it provides a flat stiff plate rather than bulk.
Only four patients received it, which establishes feasibility rather than safety or effectiveness.
Limits: the anatomical measurements come from 100 scans but the clinical experience is four cases, with no comparison group.

Why this paper matters

Running out of graft material is the central practical problem in revision rhinoplasty, and every alternative source adds a donor site. Using bone already accessible inside the nose avoids that entirely. Whether the graft holds up over years, and whether harvesting it affects the nasal airway, is unresolved.

Terms

Inferior meatus: the space beneath the lowest shelf inside the nose.
Lateral wall: the outer side wall of the nasal cavity.
Maxillary sinus: the air space within the cheekbone, connected to the nose.
Endoscopic approach: surgery performed through the nose using a lighted telescope.
Costal cartilage: cartilage from the ribs, harvested for use as a graft.
Rhinoplasty Outcome Evaluation: a patient questionnaire scoring satisfaction with the nose.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“Generally, revision rhinoplasty cases require the use of stiff grafts to restore the lost support. However, the majority of patients indicated for revision surgery present with a lack of a bony cartilaginous framework of the septum, especially after previous septoplasty. Thus, surgeons are compelled to harvest costal…”

Excerpt; the full abstract is on PubMed.