The Effect of Perichondrium and Graft Modification on the Viability of Conchal Cartilage Graft: An Experimental Study in Rabbit

2021 ◽  
pp. 105566562199817
Author(s):  
Nathania Pudya Hapsari ◽  
Kristaninta Bangun ◽  
Parintosa Atmodiwirjo ◽  
Bambang Ponco ◽  
Tri Isyani Tungga Dewi ◽  
...  
Keyword(s):  
Nasal Reconstruction ◽  
Apoptotic Cells ◽  
Cartilage Graft ◽  
Weight Changes ◽  
Cartilage Grafts ◽  
Conchal Cartilage ◽  
Structural Support ◽  
Post Test ◽  
Graft Thickness ◽  
Diced Cartilage

Objective: Cartilage grafts are widely used in reconstructing nasal deformity for structural and aesthetic purposes. Despite being immunologically privileged, cartilage grafts are susceptible to volume loss with high risk of resorption over time. Therefore, experts opt for cartilage handling modification to resolve this issue through graft dicing, wrapping, or perichondrium preservation. This study will evaluate the effect cartilage graft preparations on graft viability. Design: Single-randomized post-test-only study design. Setting: Animal Hospital at Bogor Agricultural Institute. Participants: Six New Zealand, male, Hycole rabbits. Intervention: Conchal cartilage grafts were retrieved from 6 experimental rabbits and distributed into 3 treatment groups: diced cartilage graft (DC; control), one-sided perichondrium-attached scored cartilage (OPSC), and tube-shaped perichondrium-wrapped diced cartilage (TPDC). Main Outcome Measures: Macroscopic (weight and contour) and microscopic (chondroblast proliferation, graft thickness, apoptotic cells) evaluation through histological measures were recorded on week 12. Statistical analysis was done to compare between groups. Results: Diced cartilage and OPSC groups showed significant weight changes on week 12 ( P < .05) with OPSC presenting with the biggest difference. Diced cartilage and OPSC group showed moderate cell proliferation on week 12 while TPDC displayed most abundant apoptotic cells (5.8%; P < .05). Diced cartilage group had the highest cartilage thickness ratio ( P < .05). Discussion: Bare DC technique promoted graft thickness while perichondrium-attached scored cartilage showed the most abundant chondroblast proliferation and the least apoptotic cells. Perichondrium contributes to enhanced new cartilage formation. Conclusion: Diced cartilage graft is suitable for masking irregularity and volume augmentation, while perichondrium-attached cartilage graft is better for structural support in nasal reconstruction.

The Versatile Autogenous Rib Graft in Septorhinoplasty

1998 ◽  
Vol 12 (3) ◽  
pp. 221-228 ◽  
Author(s):  
David A. Sherris ◽  
Eugene B. Kern
Keyword(s):  
Costal Cartilage ◽  
Cartilage Graft ◽  
Cartilage Grafts ◽  
Conchal Cartilage ◽  
Revision Rhinoplasty ◽  
Dorsal Onlay ◽  
Harvest Techniques ◽  
Onlay Grafts ◽  
Graft Resorption ◽  
Costal Cartilage Graft

In the graft depleted revision rhinoplasty patient and the patient with major tissue needs, alternatives to septal and conchal cartilage grafts are needed. The costal cartilage graft and rib bone/costal cartilage combination graft are excellent alternatives. In this study 14 patients received 40 grafts from 20 autogenous ribs harvested during septorhinoplasty. Materials were harvested for use as septal replacement grafts, cantilevered grafts, dorsal onlay grafts, columellar struts, and tip grafts. Patient followup was 6 to 31 months, and no evidence of graft resorption or warpage was evident during that period. Complications of harvest were minimal, and harvest techniques are detailed.

Resorbable Plates in Secondary Cleft Nasal Reconstruction

2017 ◽  
Vol 55 (2) ◽  
pp. 226-230
Author(s):  
Pey-Yi Lin ◽  
Anthony P. Gibson ◽  
John F. Teichgraeber ◽  
Matthew R. Greives
Keyword(s):  
Cleft Lip ◽  
Pediatric Population ◽  
Group Versus ◽  
Nasal Reconstruction ◽  
Cartilage Graft ◽  
Nasal Deformity ◽  
Safe Alternative ◽  
Cartilage Grafts ◽  
Plate Group ◽  
Additional Surgery

Objective: The authors report on the use and complications of alloplastic resorbable plates and compare their use to autologous cartilage grafts in secondary cleft nasal reconstruction. Design: Institutional review board (IRB)–approved retrospective chart review. Setting: Texas Cleft-Craniofacial Center at the McGovern Medical School at the University of Texas Health Sciences Center at Houston. Patients: Patients with unilateral or bilateral cleft lip nasal deformity who have undergone secondary correction of their nasal deformity with at least 1-year follow-up. Interventions: During their reconstruction, some patients had cartilage grafts used for support, whereas others were reconstructed using resorbable plates. Main Outcome Measure(s): Complications (exposure, infection, malposition, hematoma/seroma) and rates of tertiary revisions. Results: 197 patients underwent secondary cleft nasal reconstruction, with 30 patients in the resorbable plate group and 32 in the cartilage graft group. Age at surgery was 8.5±4.1 years with resorbable plates and 11.0±4.8 years with cartilage graft ( P = .03). Infection rate in the resorbable plate group and cartilage graft group were 0% and 3.25% ( P = 1). Extrusion occurred in 3 of the absorbable plate group and 2 patients with cartilage graft ( P = .67). Additional surgery was recorded in 43.3% of the resorbable plate group versus 53.1% of the cartilage graft group ( P = .459). Conclusion: The data provide evidence that the use of alloplastic resorbable plate in the pediatric population is a safe alternative to autologous septal cartilage in secondary cleft nasal reconstruction. There is no statistical difference in short-term complications or the incidence of additional nasal surgery.

Outcome of Free Diced Cartilage Grafts in Rhinoplasty: A Systematic Review

2020 ◽  
Author(s):  
Taynara Oliveira Ledo ◽  
Helena Hotz Arroyo Ramos ◽  
Cibele Madsen Buba ◽  
Guilherme Webster ◽  
Jesse Teixeira de Lima Jr ◽  
...  
Keyword(s):  
Systematic Review ◽  
Infection Rate ◽  
Systematic Search ◽  
Nasal Dorsum ◽  
Cartilage Graft ◽  
Exclusion Criteria ◽  
Cartilage Grafts ◽  
Partial Resorption ◽  
Diced Cartilage ◽  
Graft Resorption

AbstractDiced cartilage grafts are used to increase and refine the nasal contour, providing easy molding and versatility when compared with block grafts. However, all grafts present the possibility of visibility, distortion, and absorption. The aim of this study is to evaluate, through a systematic review, the outcome of the use of the free diced graft cartilage in rhinoplasty. A systematic search of the literature was performed in the databases (PubMed, Lilacs, Scielo, Cochrane) with the terms “diced cartilage” and “rhinoplasty.” Studies were selected according to the inclusion and exclusion criteria and data extracted and grouped for analysis. Six eligible studies were included. In total, 4,044 patients underwent rhinoplasty with free diced cartilage graft, with 61 (1.51%) of them requiring reoperation. The main reasons were overcorrection and irregularities of the nasal dorsum. The infection rate was reported in three studies, with 2 (0.06%) of 3,252 patients presenting infection at the graft site. Two cases of displacement were treated with external molding, without reoperation. The graft resorption was reported in four articles, which described 22 (0.67%) cases of partial resorption in 3,288 patients. Therefore, the available evidence suggests that resorption of the graft and unfavorable outcomes are rare.

Effect of Injectable Platelet-Rich Fibrin on Diced Cartilage's Viability in Rhinoplasty

2019 ◽  
Vol 35 (04) ◽  
pp. 393-396 ◽  
Author(s):  
Sercan Gode ◽  
Arin Ozturk ◽  
Veysel Berber ◽  
Erkan Kısmalı
Keyword(s):  
Control Group ◽  
Study Group ◽  
Cartilage Graft ◽  
Reliable Technique ◽  
Platelet Rich Fibrin ◽  
Resorption Rate ◽  
Group I ◽  
Postoperative Time ◽  
Graft Thickness ◽  
Diced Cartilage

AbstractDiced cartilage is one of the most widely used camouflage technique in rhinoplasty. Its variable resorption rate creates issues in postoperative time period. Platelet-rich fibrin is an autologous concentrated blood derivative containing growth factors that accelerate tissue healing. The authors evaluate the effect of injectable platelet-rich fibrin (I-PRF) on the viability of diced cartilage, which has been used for dorsum camouflage in rhinoplasty. Forty patients were randomly divided into two groups based on dorsal camouflage grafts: diced cartilage with I-PRF (study group) and diced cartilage without I-PRF (control group). Cartilage graft thickness was measured by linear superficial tissue ultrasound at the postoperative first week and the third month in both groups. The mean cartilage graft thickness loss between the first-week and third-month ultrasound measurements was 0.58 ± 0.21 mm in the study group and 0.82 ± 0.35 mm in the control group. There was significant volume loss in the control group. I-PRF was successful in reducing the resorption rate of diced cartilage on nasal dorsum by either increasing the viability or keeping its form. Sticky cartilage is an easily applicable and reliable technique that may be used to camouflage dorsal irregularities in rhinoplasty.

Porcine Mesothelium-Wrapped Diced Cartilage Grafts for Nasal Reconstruction

2018 ◽  
Vol 24 (7-8) ◽  
pp. 672-681 ◽  
Author(s):  
Athanasios Bramos ◽  
David P. Perrault ◽  
Alexander N. Fedenko ◽  
Gene H. Kim ◽  
Sofia Bougioukli ◽  
...  
Keyword(s):  
Nasal Reconstruction ◽  
Cartilage Grafts ◽  
Diced Cartilage

scholarly journals Augmentation Rhinoplasty with Rib Cartilage Graft

2015 ◽  
Vol 30 (1) ◽  
pp. 29-33
Author(s):  
Elaine Marie A. Lagura ◽  
Eduardo C. Yap ◽  
Anna Victoria G. Garcia
Keyword(s):  
Costal Cartilage ◽  
Donor Site ◽  
Cartilage Graft ◽  
Augmentation Rhinoplasty ◽  
Cartilage Grafts ◽  
Rib Cartilage ◽  
Structural Support ◽  
Alloplastic Materials ◽  
Graft Extrusion ◽  
Dorsal Nasal Augmentation

Objective: To investigate the outcome and complications of augmentation rhinoplasty with rib cartilage grafts   Methods: Study Design:            Retrospective study Setting:                       Tertiary Government Hospital Participants:              Patients who underwent dorsal nasal augmentation with autologous rib cartilage grafts between June 2008 and October 2012.   Results: A total of 12 patients (3 male, 9 female) were included in the study. Mean age was 29 years. Seven were cases of primary simple rhinoplasty with 4 cases of revision (previously using alloplastic materials) and one case of trauma. Indications for the procedure were all cosmetic. There was no incidence of infection, both in the donor and recipient sites, warping of the graft, graft extrusion, resorption, pneumothorax, chest wall deformity or prolonged edema. Post-operative pain in the donor site was relieved by oral pain medications. No revision surgery was required.   Conclusion: Costal cartilage is a good option for structural support of the nose. In our experience patients have become wary of the complication of allografts and have opted to use autografts. The surgeon’s knowledge of the nasal anatomy as well as his or her experience with autologous grafts plays a major role in avoiding post-operative morbidity. Keywords: Rhinoplasty, rib graft, costal cartilage graft, Southeast Asian nose

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