Free Diced Cartilage: A New Application of Diced Cartilage Grafts in Primary and Secondary Rhinoplasty

Abstract

The authors' findings strongly support their clinical experience that the free diced cartilage graft technique presents an effective and easily reproducible method for camouflage and augmentation in aesthetic and reconstructive rhinoplasty.

Nasal Dorsal Augmentation with Freeze-Dried Allograft Bone: 10-Year Comprehensive Review

“…Residual small pieces can be diced and packaged into a pocket, but it does not have structural strength and, although one diced dorsum remained palpable out to 6 years, 4 there is no documentation of sustainability beyond 7 months. 5,6 If these septal and ear sources are inadequate, the surgeon is faced with a significant increase in morbidity and technical difficulty with harvesting autogenous cranial bone or rib cartilage.…”

Welche Qualität macht den Unterschied?

“…Gubisch et al have further developed the procedure by using "free diced cartilage" (FDC, 2017) [104]. To enhance both augmentation and camouflage, they compared the application of FDC either without any wrapping including fibrin or with fascia or as classic DCF.…”

Free Diced Cartilage: Tips and Tricks of a Customized Procedure in Rhinoplasty

“…In fact, a fine-particle cartilage paste (particle diameter less than 0.2 mm) is realized and directly put into the desired location with a Freer elevator or, more commonly, a previously holed 1-ml syringe. 1,2 The syringe is drilled first to allow any excess fluid to be squeezed out and inject “pure” FDC through an unilateral gap infracartilaginous incision. The FDC is finally molded into the desired shape and fixed with drapes.…”

“…Furthermore, 24-gauge is a suitable size for a needle meant to drill the syringe surface, as mentioned by the authors. 1,2 In fact, a wider caliber would allow the small cartilage particles to get out of the syringe; a smaller one would be ineffective. However, as it is not a very resistant needle, it may be necessary to replace it during the procedure: its tip is likely to get blunted or bended.…”

“…The authors 1,2 suggested the insertion through the infracartilaginous incision before skin closure in the open approach. However, we would like to emphasize the extreme versatility of this method, which is also applicable in case of closed approach, by placing the FDC on site through the intercartilaginous incision.…”