Implanted cartilaginous grafts following rhinoplasty: A retrospective histopathological study.

Abstract

To describe histopathological features of rhinoplasty-related implanted cartilages, 83 cartilages surgically removed from 42 patients (2 men and 40 women) with a median age of 28.0 years (range, 21-47 years) following correction/revision rhinoplasty were examined. These cartilages included 16 autologous costal cartilages (ACCs), 14 irradiated homologous costal cartilages (IHCCs), 24 autologous nasal cartilages (ANCs), 2 irradiated homologous nasal cartilages (IHNCs), 14 autologous ear cartilages (ECs) and 13 combined cartilaginous grafts. The median chondrocytic viability in ACCs (35.9%) was higher than that of IHCCs (0.0%) and ECs (21.4%) (both, P<0.001), and showed no significant differences compared with the viability in ANCs (41.3%) (P=0.455). The median organized rate of chondroid matrix in ACCs, IHCCs, ANCs and ECs was 2.5, 1.4, 0.9 and 2.0%, respectively, and there were no significant differences among them (P=0.909). The present study revealed not only enlarged chondrocytic lacunae, chondrocytic cloning and binucleated/trinucleated chondrocytes, but also a possible transition between chondrocytes and fibroblasts in 6 ACCs, 3 ANCs and 1 EC, lipomembranous fat necrosis (LFN)-like bodies in 15 ACCs, 14 IHCCs, 3 ANCs and 5 ECs, and chondrocytic vacuolar changes in 15 ACCs, 22 ANCs, 2 IHNCs and 16 ECs. A histological transition between LFN-like bodies and chondrocytic vacuoles was focally observed in 2 ACCs and 1 ANC. The present findings suggested that the stability of implanted cartilage did not depend on chondrocytic viability only. Viable chondrocytes preserve implanted chondroid matrix, but also may, in part, induce organization through their transformation into fibroblasts. LFN-like bodies are considered to be an underrecognized form of vacuolar change-related chondrocytic necrosis.