THE ROLE OF PRESERVED AUTOGENOUS CARTILAGE GRAFT IN SEPTORHINOPLASTY

Previous reports have established the role of fresh autogenous cartilage grafts harvested at the time of surgery. This report describes the value of autogenous preserved cartilage, removed and stored at the time of initial surgery, for use in secondary surgery. This study also compares fresh and preserved cartilage used in crushed and noncrushed states in secondary rhinoplasties. From 1983 to 1990, 256 of 1,185 patients who had undergone septorhinoplasty required a revision procedure. Cartilage graft was used in 186 (72.7%) patients. Cartilage removed during the primary surgery was stored in a saline and antibiotic solution at 0-degrees-F to 2-degrees-F. The average time interval from primary to secondary surgery was 11.97 months (SD, 10.63 mo). Follow-up after graft placement averaged 44.71 months (SD, 26.21 mo). Two hundred seventy-seven pieces of cartilage were used, consisting of 16 noncrushed fresh, 136 crushed fresh, 8 noncrushed preserved, and 117 crushed preserved. Graft success rate was 93.8% for noncrushed fresh cartilage grafts, 87.5% for crushed fresh, 87.5% for noncrushed preserved, and 85.5% for crushed preserved graft. We conclude that preserved autogenous cartilage retains almost as much graft volume as fresh cartilage in rhinoplasties and eliminates the need for harvesting a graft. Cartilage removed during nasal surgery, particularly when a septoplasty is being performed, is valuable and should be stored for possible later use.