Effects of Different Cartilage Sculpting Techniques on Cellular Integrity of Nasal Septal Cartilage

Study background: Several techniques exist to sculpt nasal septal cartilage grafts for use in functional and cosmetic rhinoplasty, including the use of cold steel, Bovie electrosection and the Sonopet ultrasonic bone aspirator. This is the first investigation on the effects of these disparate tools on gross cellular integrity of sculpted cartilage. Methods: After IRB approval, extraneous nasal septal cartilage harvested during routine septoplasty and/or rhinoplasty procedures was collected from three patients treated within our institution for use in this study. Cartilage specimens from each patient were divided into four equal segments and a partial thickness trough was sculpted in the center of each piece with one of the three techniques described above. One segment remained free of any additional manipulation and served as a comparative control. Gross cellular architecture and number of viable chondrocytes were assessed with optical microscopy. Results: Minimal disruption of the cellular integrity of nasal septal cartilage samples sculpted with each of the three techniques was noted compared to control. Average cell counts revealed 96%, 97%, 97% and 97% viable nuclei in the scalpel, electrocautery, ultrasonic bone aspirator and control groups, respectively. Conclusion: Cartilage sculpting using cold steel, Bovie electrosection and the ultrasonic bone aspirator appear to have minimal effects on cellular integrity of cartilage grafts. This portends a favorable outlook on long term durability of these cartilage grafts and suggests that these three techniques can be used interchangeably for cartilage sculpting needs.