Can Bone Cements Be used To Build Up The Nose?

Q: Dr. Eppley, for nasal surgery can you use calcium phosphate cement to build up the nose? Please advise.

A: As you may know there are a large number of materials, both synthetic and autologous, that are used for nasal augmentation. The term, nasal augmentation, can be used to describe a variety of dorsal nasal procedures but in most cases refers to a build-up from the nasal bone area down to or just behind the tip. It is important to realize that the underlying anatomy changes along the dorsal line. Only the upper third of the dorsal line is comprised of bone, the lower two-thirds is cartilage. Therefore, when considering a bone cement material for nasal augmentation it would need to be restricted to that of the upper third where the cement can actually attach to the bone. Bone cements would not be good for any other dorsal line area because it will not attached to the underlying cartilage.

Can hydroxyapatite bone cements be used for nasal augmentation? Yes but it would be restricted to very limited nasal augmentation indications. Does bone cement offer any advantages over the wide variety of other more commonly used nasal implant materials? That is a matter of debate and would highly depend on the specific need and indication. But, in general, it is a very uncommonly used nasal implant material even for the bony bridge area of the nose.

Dr. Barry Eppley

Indianapolis, Indiana