A systematic review and meta-analysis Role of Diced Cartilage in Dorsal Reconstruction in Rhinoplasty

Abstract

Diced cartilage grafts in rhinoplasty were in widespread use around 70 years ago, but lost their Dpopularity post world war II. In recent years however renewed interest in this technique has emerged. The use of diced cartilage rather than a solid piece of cartilage attract surgeons because of its greater flexibility, minimal risk of warping and, obviates requirement of single large graft. A critical issue for biomaterials is absorption or extrusion and same has been presented as a concern in diced cartilage rhinoplast (Singh et al., 2014). The use of diced-cartilage grafts has become popular for dorsal reconstruction over the past decade. It has been shown to have adequate tissue in-growth. The small fragments of cartilage allow easy manipulation and avoid the complication of warping as seen with a solid-cartilage graft. Revascularization is quicker due to the increased surface area of the graft’s fragments. The challenge with the use of a diced-cartilage graft lies in the controlled insertion of the graft onto the nasal dorsum and the postoperative stability of its position (Ӧreroǧlu et al., 2014). The ideal reconstructive technique for nasal dorsum defects is still evolving. Rib cartilage continues to be the preferred grafting material for complex rhinoplasty deformities when a considerable amount of cartilage is required for dorsal augmentation. With the increased popularity of diced cartilage for dorsal nasal augmentation, there has been greater focus on wrapping methods that enclose the cartilaginous fragments and homogenously stabilize them inside the area of defect (As'adi et al., 2014).