Department of Otorhinolaryngology-Head and Neck Surgery, National Medical Center, Seoul, Republic of Korea.
Department of Pathology, National Medical Center, Seoul, Republic of Korea.
Aesthet Surg J. 2022 Jun 20;42(7):NP489-NP500. doi: 10.1093/asj/sjac028.
Costal cartilage is commonly employed as a dorsal implant in Asian rhinoplasty. To achieve better outcomes, it is important to know which types of costal cartilage are most appropriate for dorsal augmentation.
The authors investigated how various forms of costal cartilage affect the surrounding tissues and their resorption over time, as well as their clinical appearance, using histomorphological analysis.
Cartilage samples were collected from the anterior chest wall of 10 rabbits. Four forms of cartilage-2-mm solid block, 1-mm solid block, diced, and crushed-were prepared and inserted into the subcutaneous tissue pockets of the nasal dorsum of each rabbit. The animals were killed 3 and 6 months later, and graft specimens were examined.
Histomorphological analysis revealed important findings of the cartilage and surrounding tissues. The thickness of thick cartilage significantly decreased over time, but the thickness of thin cartilage did not significantly change (P = 0.038). Additionally, the thick cartilages showed a lower degree of vascularization than the thin cartilages (P < 0.001). A comparison of the cartilage forms revealed that the diced cartilages had better chondrocyte survival than the solid block cartilages (P < 0.001). Fat tissues were prominently observed surrounding the diced cartilages at 3 months (P = 0.01), and fibrosis was more prominently observed in the crushed cartilage than in the other types of cartilages (P = 0.04 and P = 0.005 at 3 and 6 months, respectively).
This study revealed differences in resorption depending on the thickness of the costal cartilage in rabbits. Among the various forms of costal cartilages, diced and thin solid-block cartilage were the best option for dorsal augmentation when considering long-term graft survival.
在亚洲鼻整形术中，肋软骨通常被用作鼻背植入物。为了获得更好的效果，了解哪种类型的肋软骨最适合鼻背增强是很重要的。
作者通过组织形态学分析研究了各种形式的肋软骨对周围组织的影响及其随时间的吸收情况，以及它们的临床外观。
从 10 只兔子的前胸壁采集软骨样本。制备 2-mm 实心块、1-mm 实心块、切丁和粉碎 4 种形式的软骨，并将其插入每只兔子鼻背的皮下组织袋中。3 个月和 6 个月后处死动物，并检查移植物标本。
组织形态学分析揭示了软骨和周围组织的重要发现。厚软骨的厚度随时间显著减少，但薄软骨的厚度没有显著变化（P = 0.038）。此外，厚软骨的血管化程度低于薄软骨（P < 0.001）。对软骨形式的比较表明，切丁软骨的软骨细胞存活率优于实心块软骨（P < 0.001）。3 个月时，明显观察到围绕切丁软骨的脂肪组织（P = 0.01），与其他类型的软骨相比，粉碎软骨中观察到更多的纤维化（3 个月和 6 个月时分别为 P = 0.04 和 P = 0.005）。
本研究揭示了兔肋软骨厚度不同导致吸收的差异。在各种形式的肋软骨中，考虑到长期移植物存活，切丁和薄实心块软骨是鼻背增强的最佳选择。
