Ankara and Istanbul, Turkey From the Otorhinolaryngology Clinic, Elmadag State Hospital; the Departments of Otorhinolaryngology and Pathology, Baskent University Faculty of Medicine; and the Department of Otorhinolaryngology, Acibadem University School of Medicine.
Plast Reconstr Surg. 2011 Nov;128(5):1045-1051. doi: 10.1097/PRS.0b013e31822b6651.
Cartilage grafts are frequently used in nasal surgery for structural and/or aesthetic purposes. The literature holds contradictory reports concerning the effect of crushing on the viability of cartilage grafts.
Nasal septal and costal cartilage grafts were harvested from 12 New Zealand rabbits. Each nasal septal and costal cartilage was divided into five equal pieces. One of the pieces was left intact and the remaining four were prepared as slightly, moderately, severely, or significantly crushed. The cartilage pieces were then autoimplanted into the paravertebral skin of the rabbits. The animals were euthanized 4 months later and the effect of crushing on cartilage grafts was assessed pathologically.
The viability of the chondrocytes was found to be decreased as the level of crushing increased. The mean chondrocyte viability rates for the intact, slightly crushed, moderately crushed, severely crushed, and significantly crushed cartilages were 88, 75, 51, 41, and 13 percent for the septal cartilages and 94, 83, 62, 32, and 26 percent for the costal cartilages, respectively. The differences between the mean viability rates of septal and costal cartilage groups were statistically not significant.
The level of crushing determines the rate of viability for the crushed cartilage. Viability rates and the clinical properties of the slightly crushed cartilage grafts at long-term follow-up may be similar to those of the intact cartilage grafts. However, severe or significant crushing leads to a decrement in the viability of the chondrocytes and may cause unpredictable degrees of volume loss at long-term follow-up.
软骨移植物常用于鼻整形术,以达到结构和/或美学目的。关于粉碎对软骨移植物活力的影响,文献中有相互矛盾的报道。
从 12 只新西兰兔中采集鼻中隔和肋软骨移植物。将每块鼻中隔和肋软骨均分为五等份。其中一份保持完整,其余四份分别轻度、中度、重度或显著粉碎。然后将软骨块自体植入兔的椎旁皮肤。4 个月后处死动物,病理评估粉碎对软骨移植物的影响。
随着粉碎程度的增加,软骨细胞的活力逐渐降低。完整、轻度粉碎、中度粉碎、重度粉碎和显著粉碎的鼻中隔软骨的平均软骨细胞活力率分别为 88%、75%、51%、41%和 13%,肋软骨分别为 94%、83%、62%、32%和 26%。鼻中隔软骨组和肋软骨组的平均活力率差异无统计学意义。
粉碎程度决定了粉碎软骨的活力率。在长期随访中,轻度粉碎软骨移植物的活力率和临床特性可能与完整软骨移植物相似。然而,严重或显著的粉碎会导致软骨细胞活力下降,并可能导致长期随访中不可预测的体积损失程度。