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A Study in Rabbits

Ozcan Cakmak, MD; Sema Bircan, MD; Fuat Buyuklu, MD; Ilhan Tuncer, MD; Teoman Dal, MD; Levent Naci Ozluoglu, MD

Arch Facial Plast Surg. 2005;7:21-26.

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 x 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.

Author Affiliations: Baskent University Faculty of Medicine, Otorhinolaryngology Department, Ankara (Drs Cakmak, Buyuklu, Dal, and Ozluoglu), and Baskent University Adana Teaching and Medical Research Center, Pathology Department, Adana (Drs Bircan and Tuncer), Turkey.

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