Facial Plast Surg 2015; 31(02): 172-180
DOI: 10.1055/s-0035-1549041
Rapid Communication
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Changes in Histopathology and Mass in Hyperbaric Oxygen–Treated Auricular Cartilage Grafts in a Rabbit Model

Suat Bilici
1   Department of Otorhinolaryngology, İstanbul Education and Research Hospital, İstanbul, Turkey
,
Özgür Yiğit
1   Department of Otorhinolaryngology, İstanbul Education and Research Hospital, İstanbul, Turkey
,
Zehra Dönmez
2   Department of Otorhinolaryngology, Haseki Education and Research Hospital, İstanbul, Turkey
,
Gülben Erdem Huq
3   Department of Pathology, İstanbul Education and Research Hospital, İstanbul, Turkey
,
Şamil Aktaş
4   Department of Underwater and Hyperbaric Medicine, İstanbul University, İstanbul, Turkey
› Author Affiliations
Further Information

Publication History

Publication Date:
08 May 2015 (online)

Abstract

The aim of the study is to investigate the histopathologic and cartilage mass changes in hyperbaric oxygen (HBO)–treated auricular cartilage grafts either crushed or fascia wrapped in a rabbit model. This is a prospective, controlled experimental study. Sixteen rabbits were randomly allocated into control (n = 8) and treatment groups (n = 8). Each group was further grouped as crushed cartilage (n = 4) and fascia wrapped crushed cartilage (n = 4). The eight rabbits in the treatment group had HBO once daily for 10 days as total of 10 sessions. The mass of cartilage, cartilage edge layout, structural layout, staining disorders of the chondroid matrix, necrosis, calcification besides bone metaplasia, chronic inflammation in the surrounding tissues, fibrosis, and increased vascularity were evaluated in the hematoxylin and eosin (H&E)–stained sections. Fibrosis in the surrounding tissue and cartilage matrix was evaluated with Masson's trichrome stain. The toluidine blue staining was used to evaluate loss of metachromasia in matrix. The prevalence of glial fibrillary acidic protein (GFAP) staining in chondrocytes was also evaluated. Although the remaining amount of cartilage mass after implantation does not show a significant difference between the control and the study group (p = 0.322, p <0.05).The difference between control and study group in terms of positive staining with GFAP was statistically significant (p = 0.01, p <0.05). Necrosis and loss of matrix metachromasia were significantly low in the study group compared with control group (p = 0.001, p = 0.006, p <0.05). HBO therapy did not have significant effect on the mass of rabbit auricular cartilage graft. HBO therapy significantly reduced loss of metachromasia, necrosis, and GFAP staining in the auricular cartilage grafts of the animal model.

Note

This study was presented as an oral presentation at the 34th Turkish National Congress of Otorhinolaryngology and Head Neck Surgery in Antalya, Turkey, October 10–14, 2012, and won the first prize in Rhinology.


 
  • References

  • 1 Cakmak O, Bircan S, Buyuklu F, Tuncer I, Dal T, Ozluoglu LN. Viability of crushed and diced cartilage grafts: a study in rabbits. Arch Facial Plast Surg 2005; 7 (1) 21-26
  • 2 McKinney P, Loomis MG, Wiedrich TA. Reconstruction of the nasal cap with a thin septal graft. Plast Reconstr Surg 1993; 92 (2) 346-351
  • 3 Skoog T. A method of hump reduction in rhinoplasty. A technique for preservation of the nasal roof. Arch Otolaryngol 1966; 83 (3) 283-287
  • 4 Reich J. The application of dermis grafts in deformities of the nose. Plast Reconstr Surg 1983; 71 (6) 772-782
  • 5 Baker TM, Courtiss EH. Temporalis fascia grafts in open secondary rhinoplasty. Plast Reconstr Surg 1994; 93 (4) 802-810
  • 6 Kamer FM, Parkes ML. Gelatin film. A useful adjunct in rhinoplastic surgery. Arch Otolaryngol 1977; 103 (11) 667-670
  • 7 Gilmore J. Use of Vicryl mesh in prevention of postrhinoplasty dorsal irregularities. Ann Plast Surg 1989; 22 (2) 105-107
  • 8 Stoll W. The use of polytetrafluoroethylene for particular augmentation of the nasal dorsum. Aesthetic Plast Surg 1991; 15 (3) 233-236
  • 9 Daniel RK, Calvert JW. Diced cartilage grafts in rhinoplasty surgery. Plast Reconstr Surg 2004; 113 (7) 2156-2171
  • 10 Erol OO. The Turkish delight: a pliable graft for rhinoplasty. Plast Reconstr Surg 2000; 105 (6) 2229-2241 , discussion 2242–2243
  • 11 Lewis D, Goldztein H, Deschler D. Use of hyperbaric oxygen to enhance auricular composite graft survival in the rabbit model. Arch Facial Plast Surg 2006; 8 (5) 310-313
  • 12 Renner G, McClane SD, Early E, Bell P, Shaw B. Enhancement of auricular composite graft survival with hyperbaric oxygen therapy. Arch Facial Plast Surg 2002; 4 (2) 102-104
  • 13 Kindwall EP, Whelan HT. Hyperbaric Medicine Practice. 2nd ed. Flagstaff, AZ: Best Publishing Co; 1999: P37-68
  • 14 Peer LA. Diced cartilage grafts. J Int Coll Surg 1954; 22 (3 Pt 1): 283-291
  • 15 Young F. Autogenous cartilage grafts. Surgery 1941; 10: 7
  • 16 Cottle MH. Nasal surgery in children. Eye Ear Nose Throat Mon 1951; 30 (1) 32-38
  • 17 Kazikdas KC, Ergur B, Tugyan K, Guneli E, Kaya D, Sahan M. Viability of crushed and diced cartilage grafts wrapped in oxidized regenerated cellulose and esterified hyaluronic acid: an experimental study. Laryngoscope 2007; 117 (10) 1728-1734
  • 18 Kim HK, Chu LS, Kim JW , et al. The viability of diced cartilage grafts wrapped in autogenous fascia and AlloDerm ® in a rabbit model. J Plast Reconstr Aesthet Surg 2011; 64 (8) e193-e200
  • 19 Drumheller GH. Comments on Huizing's paper on implantation and transplantation reconstructive nasal surgery. Rhinology 1977; 15 (1) 53-54
  • 20 Breadon GE, Kern EB, Neel III HB. Autografts of uncrushed and crushed bone and cartilage. Experimental observations and clinical implications. Arch Otolaryngol 1979; 105 (2) 75-80
  • 21 Yilmaz S, Erçöçen AR, Can Z, Yenidünya S, Edali N, Yormuk E. Viability of diced, crushed cartilage grafts and the effects of Surgicel (oxidized regenerated cellulose) on cartilage grafts. Plast Reconstr Surg 2001; 108 (4) 1054-1060 , discussion 1061–1062
  • 22 Hummerlund C. The physiologic effects of hyperbaric oxygen. In: Kindwall E, ed. Hyperbaric Medicine Practice. Flagstaff, AZ: Best Publishing Company; 1995: 17-32
  • 23 Jain KK. Textbook of Hyperbaric Medicine. 2nd ed. Seattle, WA: Hogrefe & Huber; 1996
  • 24 Buras J. Basic mechanisms of hyperbaric oxygen in the treatment of ischemia-reperfusion injury. Int Anesthesiol Clin 2000; 38 (1) 91-109
  • 25 Zamboni WA, Wong HP, Stephenson LL. Effect of hyperbaric oxygen on neutrophil concentration and pulmonary sequestration in reperfusion injury. Arch Surg 1996; 131 (7) 756-760
  • 26 Thom SR, Elbuken ME. Oxygen-dependent antagonism of lipid peroxidation. Free Radic Biol Med 1991; 10 (6) 413-426
  • 27 Buras JA, Stahl GL, Svoboda KK, Reenstra WR. Hyperbaric oxygen downregulates ICAM-1 expression induced by hypoxia and hypoglycemia: the role of NOS. Am J Physiol Cell Physiol 2000; 278 (2) C292-C302
  • 28 Rengasamy A, Johns RA. Characterization of endothelium-derived relaxing factor/nitric oxide synthase from bovine cerebellum and mechanism of modulation by high and low oxygen tensions. J Pharmacol Exp Ther 1991; 259 (1) 310-316
  • 29 Parker Porter J. Grafts in rhinoplasty: alloplastic vs. autogenous. Arch Otolaryngol Head Neck Surg 2000; 126 (4) 558-561
  • 30 Lattyak BV, Maas CS, Sykes JM. Dorsal onlay cartilage autografts: comparing resorption in a rabbit model. Arch Facial Plast Surg 2003; 5 (3) 240-243
  • 31 Gungor A, Poyrazoglu E, Cincik H, Sali M, Candan H, Ay H. The effectiveness of hyperbaric oxygen treatment in tracheal reconstruction with auricular cartilage grafts (experimental study). Am J Otolaryngol 2003; 24 (6) 390-394
  • 32 Nichter LS, Morwood DT, Williams GS, Spence RJ. Expanding the limits of composite grafting: a case report of successful nose replantation assisted by hyperbaric oxygen therapy. Plast Reconstr Surg 1991; 87 (2) 337-340
  • 33 Rapley JH, Lawrence WT, Witt PD. Composite grafting and hyperbaric oxygen therapy in pediatric nasal tip reconstruction after avulsive dog-bite injury. Ann Plast Surg 2001; 46 (4) 434-438
  • 34 Elwany MS, Radi SH, Foda HT, Magdy E, Kalsa RR. Fate of implanted autologous cartilage grafts in rabbits: an experimental histological study. Bull Alex Fac Med 2006; 42 (4) 1152-1157
  • 35 Sridharan G, Shankar AA. Toluidine blue: a review of its chemistry and clinical utility. J Oral Maxillofac Pathol 2012; 16 (2) 251-255
  • 36 Wittchow R, Landas SK. Glial fibrillary acidic protein expression in pleomorphic adenoma, chordoma, and astrocytoma. A comparison of three antibodies. Arch Pathol Lab Med 1991; 115 (10) 1030-1033
  • 37 Dolman CL. Glial fibrillary acidic protein and cartilage. Acta Neuropathol 1989; 79 (1) 101-103