Viability of Crushed and Diced Cartilage Grafts

Abstract

Objective: To investigate the effects of dicing and different degrees of crushing on cartilage graft viability and outcome in rhinoplasty. Methods: Cartilage was harvested from both ears of 29 rabbits. For each animal, 6 cartilage pieces were prepared as follows and inserted into the paraspinal subcutaneous tissue: (1) left intact, (2) diced to approximately 1 × 1-mm pieces and then wrapped in oxidized regenerated cellulose, (3) slightly crushed, (4) moderately crushed, (5) significantly crushed, and (6) severely crushed. Animals were killed at 2, 5, and 10 months, and graft specimens were microscopically examined. Results: As crushing intensity rose, cartilage viability decreased and more cartilage tissue was transformed to connective tissue. The intact and slightly crushed grafts showed significant chondrocyte proliferation. This decreased as crushing intensity increased, and the severely crushed and diced cellulose-wrapped grafts exhibited almost no peripheral chondrocyte proliferation. Conclusions: Slight crushing of a cartilage graft can produce outstanding graft material that forms softer nasal contours and fills defects well. However, severe crushing of cartilage grafts results in extensive necrosis and eventual reduction in graft volume. The use of oxidized regenerated cellulose to wrap diced cartilage grafts also tends to reduce clinical predictability owing to negative effects on cartilage viability and regeneration.

Closure of Nasal Septal Perforations Using a Diced Cartilage in Fascia Graft

“…Histopathologic studies have shown that crushing of cartilage compromises chondrocyte viability to a greater extent than dicing. 40,41 We agree with other works that dicing the cartilage, adding fibrin glue, and wrapping it in fascia is crucial for graft survival in this method. In this context, we used cartilage dices of approximately 1.0 to 1.5 mm in diameter due to their high viability and stability as shown by experimental work of Dong et al 42 Third, to restore the integrity of the septum using a free graft, wound healing and graft survival are the most important factors.…”

Closure of Nasal Septal Perforations Using a Diced Cartilage in Fascia Graft

“…Histopathologic studies have shown that crushing of cartilage compromises chondrocyte viability to a greater extent than dicing. 40,41 We agree with other works that dicing the cartilage, adding fibrin glue, and wrapping it in fascia is crucial for graft survival in this method. In this context, we used cartilage dices of approximately 1.0 to 1.5 mm in diameter due to their high viability and stability as shown by experimental work of Dong et al 42 Third, to restore the integrity of the septum using a free graft, wound healing and graft survival are the most important factors.…”

Cartilage Chips in Rhinoplasty

“…They found that the mean proportion of viable cartilage observed in the specimens was 10% for diced cellulose-wrapped grafts, 10% for severely crushed grafts, 30% for significantly crushed grafts, 50% for moderately crushed grafts, 70% for slightly crushed grafts, and 90% for intact cartilage. 14 Similar results have been reported by different studies. [15][16][17] The main reason that senior surgeons have rarely been using crushed or morselized grafts is the unpredictable viability of these grafts, which can end up with irregularities.…”

Efficacy of platelet-rich fibrin matrix on viability of diced cartilage grafts in a rabbit model

“…Significant differences were found in the rate of cartilage resorption among the groups. Our study supported other studies for which the viability potential of cartilage graft wrapped with Surgicel was lower with higher resorption capability . When the higher level of resorption in cartilage grafts wrapped with Surgicel was considered, modification of the cartilage by wrapping it with biocompatible materials was suggested .…”

Closure of Nasal Septal Perforations Using a Diced Cartilage in Fascia Graft

“…Histopathologic studies have shown that crushing of cartilage compromises chondrocyte viability to a greater extent than dicing. 40,41 We agree with other works that dicing the cartilage, adding fibrin glue, and wrapping it in fascia is crucial for graft survival in this method. In this context, we used cartilage dices of approximately 1.0 to 1.5 mm in diameter due to their high viability and stability as shown by experimental work of Dong et al 42 Third, to restore the integrity of the septum using a free graft, wound healing and graft survival are the most important factors.…”

Cartilage Chips in Rhinoplasty

“…They found that the mean proportion of viable cartilage observed in the specimens was 10% for diced cellulose-wrapped grafts, 10% for severely crushed grafts, 30% for significantly crushed grafts, 50% for moderately crushed grafts, 70% for slightly crushed grafts, and 90% for intact cartilage. 14 Similar results have been reported by different studies. [15][16][17] The main reason that senior surgeons have rarely been using crushed or morselized grafts is the unpredictable viability of these grafts, which can end up with irregularities.…”

Efficacy of platelet-rich fibrin matrix on viability of diced cartilage grafts in a rabbit model

“…Significant differences were found in the rate of cartilage resorption among the groups. Our study supported other studies for which the viability potential of cartilage graft wrapped with Surgicel was lower with higher resorption capability . When the higher level of resorption in cartilage grafts wrapped with Surgicel was considered, modification of the cartilage by wrapping it with biocompatible materials was suggested .…”

Closure of Nasal Septal Perforations Using a Diced Cartilage in Fascia Graft

“…Histopathologic studies have shown that crushing of cartilage compromises chondrocyte viability to a greater extent than dicing. 40,41 We agree with other works that dicing the cartilage, adding fibrin glue, and wrapping it in fascia is crucial for graft survival in this method. In this context, we used cartilage dices of approximately 1.0 to 1.5 mm in diameter due to their high viability and stability as shown by experimental work of Dong et al 42 Third, to restore the integrity of the septum using a free graft, wound healing and graft survival are the most important factors.…”

Cartilage Chips in Rhinoplasty

“…They found that the mean proportion of viable cartilage observed in the specimens was 10% for diced cellulose-wrapped grafts, 10% for severely crushed grafts, 30% for significantly crushed grafts, 50% for moderately crushed grafts, 70% for slightly crushed grafts, and 90% for intact cartilage. 14 Similar results have been reported by different studies. [15][16][17] The main reason that senior surgeons have rarely been using crushed or morselized grafts is the unpredictable viability of these grafts, which can end up with irregularities.…”

Efficacy of platelet-rich fibrin matrix on viability of diced cartilage grafts in a rabbit model

“…Significant differences were found in the rate of cartilage resorption among the groups. Our study supported other studies for which the viability potential of cartilage graft wrapped with Surgicel was lower with higher resorption capability . When the higher level of resorption in cartilage grafts wrapped with Surgicel was considered, modification of the cartilage by wrapping it with biocompatible materials was suggested .…”