Can we add auricular composite graft to our rhinoplasty armamentarium?

The ala of the nose, with its particular texture and characteristics, poses both aesthetically and functionally intriguing challenges and is rather problematic regarding choices for reconstructive methods. Both flaps and grafts have been used to restore natural structure of nasal ala. The present study summarizes a ten-year experience of reconstructive surgery using small composite grafts from non-cartilage bearing tissues, and large composite grafts, containing cartilaginous tissue, with a mean follow-up of 4 years and 8 months. Cumulatively 56 patients were reported. Some of them required surgery due to previous cosmetic rhinoplasty. In 47 of the cases, a small graft from the non-cartilage bearing junction of ear lobule to helical rim sufficed. Nine patients had rather large defects for which grafts were harvested from the helical root. Donor sites were primarily closed and grafts were implanted in place in a single, rapid session. All small grafts had excellent take. Of 9 large grafts, 5 had excellent take, three had acceptable, and one, in a male smoker, failed to take. During follow-up, no gross deformity or poor scar was detected in either donor or recipient site. We have demonstrated that using both large and small auricular composite grafts has favorable long term results for reconstruction of alar rim deformities. However, use of small grafts seems more beneficial and applicability of large grafts requires further studies

Effects of platelet-rich plasma on cartilage grafts in rabbits as an animal model

Cartilage tissue has limited regenerative capacity and the management of cartilage defects has always been a challenging issue. Platelet-rich plasma [PRP] has been recently been used to improve healing of cartilage defects. In the present experiment, we aimed to investigate the effects of PRP on regeneration capacity as well as survival of the cartilage grafts in a rabbit model. In 15 white New Zealand rabbits, auricular cartilage was used to produce 4 pieces of cartilage [each about 2×2 cm]. Two samples were diced to small pieces and 2 samples left intact. PRP was prepared using 5 ml of auricular blood. After measuring of the weight and volume of cartilages, they mixed with either normal saline or PRP and then implanted on the back of the rabbit. After 12 weeks, the implants were removed and the weight and volume were measured and the numbers of nucleated lacunae were counted on H and E staining. Histological findings showed that in both the intact and diced cartilages, adding PRP resulted in increasing regeneration of chondrocytes. Moreover, adding PRP to intact cartilages had a significant effect in maintaining the grafts 'weight and volume [p<0.05] but in diced cartilages, this effect was not significant. Our findings yielded valuable information on the effect of PRP on survival and regeneration of autologous cartilage grafts as the extent of angiogenesis and the diameters of vessels were more pronounced in the side using PRP and markedly lesser reduction of weight and volume were visible in this group. PRP was effective in increasing survival and regeneration capacity of cartilage grafts in rabbit model