Nasal Tip Remodeling Using Autologous Cartilage Grafts: Systematic Review.

Abstract

The objective of this study was to perform a systematic review of the literature to assess the clinical outcomes and safety profile of autologous cartilage grafts (A-CGs) in nasal tip remodeling (NTR). The protocol was developed following the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses-Protocols guidelines. A multistep search of the PubMed, MEDLINE, Embase, Scopus database, and Cochrane databases has been performed to identify papers on A-CGs use in NTR. Of the 253 articles initially identified, only 39 articles providing either retrospective (n = 35) or prospective (n = 4) data about outcomes, descriptions, and complications of the A-CGs use in NTR were selected. Of these, 3 articles focused on alloplastic grafts were excluded. The nasal septum, concha, and ribs have been the main donor sites to build A-CGs to be used in NTR. Septal cartilage turned out to a specific and versatile, useful for many types of grafts tools, presenting a low rate of resorption, extrusion, and warping. Auricular concha cartilage has been used to correct both the internal and external nasal valve collapse, whereas rib chondral grafts have been used to improve the structural support when septal cartilage was not available. Crushed cartilage, minced cartilage, and diced cartilage have been used in noses with thinner soft tissues. Eighty percent of the analyzed studies focused on the description of the adopted surgical technique and A-CGs procedures of preparation, displaying encouraging aesthetic and functional outcomes with generally low levels of complications. Collected data confirmed the safety and efficacy of A-CGs-related interventions in NTR without major side effects.