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 1cmx1cm were
prepared and inserted as follows into the paraspinal subcutaneous tissue: (1)
left intact, (2) diced to approximately 1x1mm 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 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. |
