Pathomorphologic changes in the autologous auricular cartilage graft after rhinoplasty

The autologous auricular cartilage is frequently used in septorhinoplasty surgery. Considering that rinoplasty is one of the most difficult surgical procedures the revision rate remains high. We examined the superfluous fragments of auricular cartilage grafts obtained during the revision surgery to asses their vitality and possible changes arising from graft survival in different environment. The pathomorphological and imunohistochemical methods were used.

Histological evaluation showed that the explanted fragments were surrounded by fibrous capsule including blood vessels. In comparison to control group transplanted grafts had typical characteristics of elastic cartilage. The elastic fibres were preserved with occasional local fragmentation. However, the tissue of explanted grafts showed the presence of irregullary distributed small fibrous scars lacking chondrocytes and containing only very sparse elastic fibres. The most significant difference was decreased number of surviving chondrocytes and increased amount of so-called empty lacunae lacking any cellular structure. The number of these lacunae was 3-fold higher when compared to healthy controls. Moreover, in contrast to control specimens alpha-actin positive chondrocytes occurred very rarely. We did not observe CD 68 positivity in the cytoplasm of chondrocytes. Thus, increased autophagic activity in cells, sometimes preceding apoptosis, could be excluded. No signs of remodelation, proliferation activity of chondrocytes or inflammatory reaction within the cartilage or in an adjacent tissue were observed.

In conclusion auricular cartilage is well tolerated as a grafting material in rhinoplasty and maintains its structural characteristics despite several changes in its structure occuring after transplantation.

Publication History

Article published online:
10 June 2020