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

Ledo, Taynara Oliveira; Ramos, Heloisa; Buba, Cibele Madsen; Webster, Guilherme; Lima, Jesse Teixeira de; Paiva, Diógenes Lopes de; Jurado, José Roberto Parisi

doi:10.1055/s-0040-1714664

Cited by 11 publications

(5 citation statements)

References 14 publications

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“…Daniel concluded that diced costal cartilage was ideal for the prevention of resorption compared with blocks of cartilage [14]. A recent systematic review on the outcome of diced cartilage in rhinoplasty reported 0.67% (22/3288) of patients suffered from partial resorption [19], which is consistent with the present study.…”

Section: Discussionsupporting

confidence: 90%

Paranasal Augmentation Using Diced Costal Cartilage for Midface Concavity: A Retrospective Study of 68 Patients

Dong

Han

et al. 2021

Aesth Plast Surg

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Background Paranasal augmentation was effective management for midface concavity. Both alloplastic graft (e.g. silicone, porous polyethylene, or expanded polytetrafluorethylene) and autologous tissue (e.g. costal cartilage) were used for paranasal augmentation. The study aims to evaluate the safety and efficacy of paranasal augmentation using diced costal cartilage for midface concavity. Methods A retrospective review of demographic data and complications was conducted for consecutive patients who underwent paranasal augmentation using diced costal cartilage. A questionnaire was used for investigating the patient's satisfaction (i.e. overall satisfaction, bilateral alar bases symmetry, improvement of concavity, and foreign body sensation). Patients' photographs were used to evaluate aesthetic outcomes (i.e. overall satisfaction, bilateral alar bases symmetry, and improvement of concavity) by third-party doctors. Results Sixty-eight patients (60 females; mean age, 27.1 ± 8.2 years) were included. During a median follow-up of 6.5 months, costal cartilage migration occurred in 13 (19.1%) patients and partial resorption occurred in 2 (2.9%) patients. Seventy-five per cent of the patients and 98.5% of the doctors reported overall satisfaction. Bilateral alar bases asymmetry by 20 (29.4%) patients, no improvement of concavity by 13 (19.1%) patients, and foreign body sensation by 13 (19.1%) patients were reported. While bilateral alar bases asymmetry was not reported, improvement of concavity was reported in 67 (98.5%) patients by third-party doctors. On both univariate and multivariate analyses, improvement of concavity was significantly associated with patients' overall satisfaction (p = 0.008 and 0.045, respectively), while bilateral alar bases symmetry and foreign body sensation were not (all p [ 0.05). Conclusions Paranasal augmentation using diced costal cartilage seems a safe and effective method for midface concavity. Improvement of concavity may be significantly associated with patients' overall satisfaction.

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Section: Discussionsupporting

confidence: 90%

Paranasal Augmentation Using Diced Costal Cartilage for Midface Concavity: A Retrospective Study of 68 Patients

Dong

Han

et al. 2021

Aesth Plast Surg

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“…Our 5-year follow-up findings showed that the implants maintained an appropriate shape in all patients, without any deformation or displacement. In addition, because ICM exhibits much lower hardness, compared with the diced or crushed autologous cartilage grafts that are often used in clinical rhinoplasty procedures, [29][30][31][32] ICM grafts can more easily be used in minimally invasive rhinoplasty; they can accurately match the dorsal contour shape by means of subcutaneous pressure, thus avoiding dorsal contour irregularities and the appearance of graft edges. Notably, the mechanical strength of the implanted graft could become similar to the strength of native nasal cartilage during growth into mature regenerated cartilage; it could also adequately integrate with surrounding tissue in recipient sites, without floating and moving, thus maintaining satisfactory shape.…”

Section: Discussionmentioning

confidence: 99%

Injectable Cartilage Microtissue Regenerated by Autologous Chondrocytes for Nasal Augmentation: A 5-Year Follow-Up Study

Li¹,

Yin²,

Liu³

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: A lack of ideal filling materials is a critical limitation in current rhinoplasty. Cartilage sheet regeneration by autologous chondrocytes is expected to provide an ideal source of material. However, the inability to perform minimally invasive transplantation of cartilage sheets has greatly limited the clinical application of this material. In this article, the authors propose the concept of injectable cartilage microtissue (ICM) based on cartilage sheet technology, with the aim of achieving minimally invasive augmentation rhinoplasty in clinical practice. Methods: Approximately 1.0 cm 2 of posterior auricular cartilage was collected from 28 patients. Isolated chondrocytes were expanded, then used to construct autologous cartilage sheets by high-density seeding and in vitro culture in chondrogenic medium with cytokines (eg, transforming growth factor beta-1 and insulinlike growth factor-1) for 3 weeks. Next, ICM was prepared by granulation of the cartilage sheets; it was then injected into a subcutaneous pocket for rhinoplasty. Results: ICM was successfully prepared in all patients, and its implantation efficiently raised the nasal dorsum. Magnetic resonance imaging confirmed that regenerative tissue was present at the injection site; histologic examinations demonstrated mature cartilage formation with typical cartilage lacunae and abundant cartilage-specific deposition of extracellular matrix. Excellent or good postoperative patient satisfaction results were achieved in 83.3% of patients over 5 years of follow-up. Obvious absorption of grafts occurred in only two patients (8.3%). Conclusions: These results demonstrated that ICM could facilitate stable cartilage regeneration and long-term maintenance in the human body; the implantation of ICM enabled natural augmentation of the depressed nasal dorsum.

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“…ing graft. In addition, it can be useful to make a dorsal graft with diced cartilage to prevent possible complications such as warping [25]. If the amount of harvested cartilage for dorsal augmentation is sufficient, the desired shape of the implant can be created using diced cartilage with tissue glue [26].…”

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confidence: 99%

Dissection Manual for Open Rhinoseptoplasty in a Silicone Nose Model

et al. 2022

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Open rhinoseptoplasty has been widely performed in the field of otorhinolaryngology. However, from the perspective of beginners, rhinoseptoplasty is a hard-to-learn surgery that involves a relatively steep learning curve. Therefore, practical guidance is essential to enhance the skills needed for excellent surgical outcomes. Here, we provide a step-wise dissection manual using a commercialized silicone nose model designed for rhinoseptoplasty. The contents include general approaches with regard to transcolumellar inverted V incision, flap elevation, osteotomy, septoplasty, modification of the lower lateral cartilage for tip surgery, and dorsal augmentation using silicone implants. In addition, we introduce novel techniques such as dorsal augmentation using a ready-made mold with tissue glue applied to diced cartilage and polycaprolactone mesh for rhinoseptoplasty. The present study also provides photos of individual surgical procedures using a silicone nose model for actual guidance. The authors expect that this manual will help beginning rhinoseptoplasty surgeons improve their confidence.

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

Cited by 11 publications

References 14 publications

Paranasal Augmentation Using Diced Costal Cartilage for Midface Concavity: A Retrospective Study of 68 Patients

Paranasal Augmentation Using Diced Costal Cartilage for Midface Concavity: A Retrospective Study of 68 Patients

Injectable Cartilage Microtissue Regenerated by Autologous Chondrocytes for Nasal Augmentation: A 5-Year Follow-Up Study

Dissection Manual for Open Rhinoseptoplasty in a Silicone Nose Model

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