Is Cadaver Cartilage for Revision Better Than Ear Cartilage?

Question

I need to have a septal hole repaired along with augmentation of an upturned shortened nose from a previous rhinoplasty. Found a wonderful ENT/PS who recommends cadaver cartilage. He can use that or one or both of my ears. I am reading so much on the possibility of warping and reabsorption that I am so confused. What are the experiences of most revisionist these days? Is cadaver cartilage really safe? What happens if it does warp or reabsorb? Thank you very much for the advice.

Otto Joseph Placik, MD · Answer

There appear to be trends and conflicting information on the use of irradatiated rib cartilage. Clearly the advantages are that no donor site or additional srugery is necessary. However, any rib cartilage yours or a cadaver can warp. Interventions such as metal wires placed into the graft may help minimize this tendency but may require removal at a later date. Ear cartilage will not be rejected but the ability to shape of provide sufficient bulk or structure may be more limited.

Rod J. Rohrich, MD · Answer

There are Pros and Cons for using Irradiated vs Autologous Rib Cartilage in Revision Rhinoplasty Patients-

	1. Irradiated Rib Cartilage- No donor site morbidity, ease of use , less warping but more resorption than Autologous Rib Cartilage

	2. Autologous Rib Cartilage- Abundant, donor site morbidity, ease of carving, more warping tendency but less resorption .

	In my personal experience, I have moved to using only autologous material- septum , ear or rib in the management of revision rhinoplasty patients for enhanced long term results, safety ,and less resorption rates .

Daniel Reichner, MD, FACS · Answer

Good question. There is still some controversy regarding the use of irradiated cadaveric rib cartilage in nasal reconstruction. The main concern was not safety, but resorption of the homologous rib graft over time. Recent studies have shown that about one third of these grafts will lose support and resorb over time. This would be a problem in cases like yours, were the surgeon is trying to lengthen the nose or reconstruct the septum. In bigger reconstructive cases, a patient's own rib cartilage would be my first choice. However, if (for whatever reason) rib harvest is not available, then irradiated homologous rib grafts would be my next best option in these cases.

Kevin Sadati, DO · Answer

Dear Rhinoplasty Patient from Florida,
	Irradiated cadaver cartilage is an excellent choice for most revision rhinoplasty cases. Remember having cartilage harvested from your ears or ribs requires additional surgery and recovery. It seems your facial plastic surgeon has a good handle of the situation. Talk to him for more information. Good luck.

Steven Wallach, MD · Answer

Irradiated cartilage like any cartilage to be use can warp after use.  It is a good substitute to avoid having rib harvesting done which can be quite painful post-op.

Is Cadaver Cartilage for Revision Better Than Ear Cartilage?

Answers (7)