Histology and Long-term Stability of Diced Cartilage Graft for Revision Rhinoplasty in a Cleft Patient

Abstract

Diced cartilage graft wrapped in Surgicel or fascia has been widely reported in the literature. Pure diced cartilage graft without the use of a "sleeve," on the contrary, is not as commonly reported. This could be due to concerns of graft dispersion, palpability, or visibility. In this case report, histologic findings of a pure diced cartilage graft placed 4½ years ago are reported. In addition, advantages and disadvantages of this technique are discussed in detail. Two pieces of the diced cartilage graft placed 4½ years prior were excised and sent for histologic analysis during a revision procedure. The microscopic examination reveals several small blocks of mature hyaline cartilage embedded in dense fibrous connective tissue with widely scattered small vascular channels. The cartilage is vital with scattered chondrocytes within their lacunae. Histology of the diced cartilage graft demonstrated viability and stability of the graft 4½ years after insertion. This case report also suggests that pure diced cartilage graft can provide reliable volume augmentation of nasal dorsum in cleft rhinoplasty.

Fig. 1.

Gross specimens sent for histologic analysis. Clusters of diced cartilages were surrounded by connective tissue.

Fig. 2.

A, Blocks of mature hyaline cartilage embedded in dense fibrous connective tissue (hematoxylin and eosin stain; original magnification, 4×). B, Mature fibrous stroma with intermixed cartilage and a mild patchy lymphocytic infiltrate (hematoxylin and eosin stain; original magnification, 10×). C, Vital hyaline cartilage with scattered chondrocytes within their lacunae (hematoxylin and eosin stain; original magnification, 20×).