Cartilage grafting has been used extensively to correct nasal framework deformities and irregularities
which often become apparent after edema subsides.
The objective of this study was to investigate the effects of dicing and different degrees of crushing on
cartilage graft viability and outcome.
Methods: Cartilage was harvested from both ears of 48 rabbits. For each animal, 6 cartilage pieces
without perichondrium each lcmxlcm were prepared and inserted as follows into the paraspinal
subcutaneous tissue: (1) left intact, (2) diced to approximately Ixlmm pieces and then wrapped in
oxidized regenerated cellulose (surgicell) (3) slightly crushed, (4) moderately crushed, (5) significantly
crushed, and (6) severely crushed. Animals were killed at 3, 6 and 9 months, and graft specimens were
reassessed for area of graft recovered and microscopically examined.
Results: Data collected from 42 rabbits as 6 had died. As crushing intensity rose, cartilage viability
decreased and more cartilage tissue was transformed to connective tissue. The intact and slightly crashed
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 crashing 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. |
