Search Results (15)

Background: Costal cartilage is the preferred structural material for augmentation rhinoplasty when robust and durable tip support is required. However, conventional full-thickness harvest is associated with significant donor-site morbidity, and commonly employed rigid fixation strategies—such as the septal extension graft—substantially restrict postoperative nasal tip compliance. The present study introduces a novel two-component technique combining a half-harvest costal cartilage procurement method with a pyramidal-shaped columellar strut graft anchored on the floating-tip principle, with the objective of maintaining postoperative nasal tip flexibility while providing structural support following augmentation rhinoplasty. Methods: A retrospective review was performed of consecutive patients who underwent primary or revision augmentation rhinoplasty using the pyramidal costal cartilage columellar strut graft technique by a single surgeon between June 2018 and February 2026. The medial half of the conjoined costal cartilage at the seventh, eighth, or ninth rib was procured via a half-harvest approach, preserving the lateral cortex and perichondrium to minimize donor-site morbidity and potential cartilage regeneration was considered a theoretical benefit. The harvested cartilage was carved into a pyramidal columellar strut and secured to the anterior nasal spine using a floating fixation construct; the inferior base of the strut was rigidly fixed to the nasal septum and anterior nasal spine with a minimum of three PDS 5-0 sutures, while the superior portion remained free to preserve physiologic nasal tip mobility. Adjunctive cap and shield grafts, perichondrial wrapping, and dermal fat grafts were employed as indicated. Primary outcomes included nasal tip projection, postoperative tip mobility, donor-site morbidity, and surgical complication rates. Results: Favorable clinical observations of maintained tip projection were noted throughout follow-up. Manual postoperative examination suggested preservation of tip flexibility in most patients; however, no validated objective mobility assessment tool was available. The revision rate for clinically significant tip deviation was low. No major donor-site adverse events—including pneumothorax or rib fracture—were encountered. Postoperative chest wall pain was minimal and transient, with most patients resuming daily activities within one week of surgery. Conclusions: The pyramidal-shaped costal cartilage columellar strut graft with half-harvest technique is a novel, biomechanically informed, and technically reproducible approach to augmentation rhinoplasty that was developed to address donor-site morbidity and postoperative tip rigidity, two commonly recognized limitations of conventional costal cartilage rhinoplasty: donor-site morbidity and postoperative nasal tip rigidity. Preservation of the lateral cortex and perichondrium during procurement may contribute to reduced postoperative donor-site discomfort, accelerates functional recovery, and may promote endogenous cartilage regeneration over time. The anatomically derived pyramidal strut geometry, combined with floating fixation to the anterior nasal spine, was designed to approximate the native columellar architecture, enabling consistent preservation of physiologic nasal tip mobility. The present series demonstrated a favorable safety profile with a low overall complication rate and an absence of major donor-site adverse events. Prospective studies with validated objective outcome measures are required to confirm these findings, to delineate the optimal patient selection criteria, and to establish evidence-based long-term outcome benchmarks for this technique. Full article

Background/Objectives: Septal deviation is a common cause of nasal obstruction, and achieving long-lasting septal straightening while preserving cartilage remains a surgical challenge. In this study, we describe and evaluate a simple suture technique designed to effectively straighten the nasal septum in both experimental and clinical settings. Methods: The technique combines cartilage scoring with the placement of a mattress suture to correct septal deformities. It was first tested in vitro using fifteen rabbit ear cartilage specimens and subsequently applied in vivo in a clinical series of forty-five patients presenting with septal deviation. The approach was assessed for ease of application, suitability in difficult anatomical regions (including severe caudal or dorsal deviations), cartilage preservation, and durability of correction. Clinical outcomes were followed for up to twelve months. Results: The combined scoring and mattress suture technique successfully straightened cartilage in both experimental and clinical applications. The method proved technically straightforward and applicable even in challenging septal areas. It allowed for conservative management with increased cartilage preservation. In the patient cohort, initial favorable outcomes were maintained throughout follow-up period. Conclusions: This simple suture technique represents an effective and conservative method for septal straightening. It is easy to perform, preserves cartilage, and seems to provide stable short- to mid-term results. The method may be particularly useful in cases of severe caudal or dorsal septal deviation. Full article

Background: Energy-based techniques for septal cartilage reshaping, including laser-mediated cartilage reshaping (LCR) and electromechanical reshaping (EMR), have been investigated for more than three decades as minimally invasive alternatives to conventional septoplasty. Despite encouraging preclinical findings, their clinical translation remains limited. Their relevance to personalized medicine lies in the possibility of tailoring septal correction to individual anatomy, cartilage-dominant deformity patterns, and patient-specific functional needs. Objective: To systematically review the experimental and clinical evidence on LCR and EMR for nasal septal cartilage reshaping and to evaluate their potential role within a personalized, function-oriented treatment framework. Methods: A PRISMA 2020-compliant systematic search of PubMed, Scopus, and Web of Science was performed for English-language studies published up to June 2025. Original experimental or clinical studies investigating LCR or EMR applied to human or animal septal cartilage were included. Because of heterogeneity in models, dosimetry, and outcome reporting, a qualitative synthesis was undertaken. A design-specific critical appraisal was also performed. Results: Eighteen studies met the inclusion criteria (LCR: n = 9; EMR: n = 9). LCR consistently induced shape change within a narrow thermo-mechanical relaxation range (55–75 °C), but showed dose-dependent risks of chondrocyte injury and matrix degeneration, with limited applicability to complex osseocartilaginous deviations. Only three human LCR studies were identified, all short-term and limited to mild cartilaginous deformities. EMR produced reproducible, charge-dependent reshaping at near-physiological temperatures, but human studies were lacking. Neither technique addressed bony deviations, and none assessed functional benefit using computational fluid dynamics. Conclusions: Both techniques remain predominantly preclinical and may currently serve only as adjunctive options for selected anterior, cartilage-dominant deformities. Future translation will require validated dosimetry, long-term human data, and patient-specific functional assessment. Full article

Articular cartilage (AC) damage heals poorly and can progress to osteoarthritis. Implantation of AC fragments (Minced Cartilage Implantation, MCI) is a promising one-step repair technique but is constrained by the limited availability of healthy AC. In this study, we evaluated the feasibility of MCI using nasal septal cartilage (NSC) as an alternative source of hyaline tissue with strong regenerative capacity. NSC obtained from rhinoplasties was decontaminated using a novel protocol, minced with or without Poloxamer 188 (P188), embedded in collagen I gel (0.5 mL per sample), and cultured for 42 days in platelet-rich plasma (PRP)-supplemented medium. The decontamination procedure with a combination of antibiotics was effective and did not impair cell viability. Histology of the resulting constructs confirmed robust cellular outgrowth and matrix deposition. Tissues produced from NSC and fragmented with P188 contained more cartilaginous matrix than those from NSC fragmented without P188 and those from AC fragmented with P188. NSC fragments embedded in a 1 mL hydrogel, sufficient for clinically relevant defect volumes, also demonstrated strong outgrowth and satisfactory matrix formation. Overall, the developed protocol supports the use of NSC as a viable tissue source in gel-based, injectable MCI grafts for focal cartilage repair. Full article

This comprehensive review examines the role of septoplasty in the pediatric population, emphasizing its therapeutic significance in relieving nasal obstruction and facilitating normal craniofacial growth. Despite the evident advantages of septoplasty, its application in young patients remains a subject of ongoing debate. This issue is primarily characterized by concerns regarding the still-developing immaturity of nasal cartilage, potential intraoperative and postoperative risks, and the current absence of robust data on long-term outcomes following septoplasty. Common complications such as bleeding, septal perforation, saddle nose deformity, and persistent nasal obstruction are reported in the literature; however, many studies lack long-term follow-up data on the incidence of these adverse events and revision rates, which may be higher compared to adult populations, often leading to the need for secondary surgical interventions. Strict inclusion criteria and comprehensive patient selection are paramount to maximize therapeutic success while minimizing complications. Current evidence suggests that appropriately indicated septoplasty can improve airway patency, support optimal facial development, and reduce the risk of secondary sinonasal pathology. There is a significant necessity for additional prospective, large-scale studies to establish standardized therapeutic guidelines and management strategies for this specific population, thereby ensuring effective and evidence-based pediatric otolaryngologic care. Full article

Nasal septal cartilage tissue engineering is a promising and dynamic field with the potential to provide surgical options for patients with complex reconstruction needs and mitigate the risks incurred by other tissue sources. Developments in cell source selection, cell expansion, scaffold creation, and three-dimensional (3D) bioprinting have advanced the field in recent years. The usage of medicinal signaling cells and nasal chondroprogenitor cells can enhance chondrocyte proliferation, stimulate chondrocyte growth, and limit chondrocyte dedifferentiate. New scaffolds combined with recent innovations in 3D bioprinting have allowed for the creation of more durable and customizable constructs. Future developments may increase technical accessibility and manufacturability, and lower costs, to help incorporate these methods into pre-clinical studies and clinical applications of septal cartilage tissue engineering. Full article

Background: Cartilage harvest and transplantation is a common surgery using costal, auricular, and septal cartilage for craniofacial reconstruction. However, absorption and warping of the cartilage grafts can occur due to inflammatory factors associated with wound healing. Transcription factor nuclear factor-κB (NF-κB) is activated by the various stimulation such as interleukin-1 (IL-1), and plays a central role in the transactivation of this inflammatory cytokine gene. Inhibition of NF-κB may have anti-inflammatory effects. The aim of this study was to explore the potential of an NF-κB decoy oligodeoxynucleotide (Decoy) as a chondroprotective agent. Materials and Methods: Safe and efficacious concentrations of Decoy were assessed using rabbit nasal septal chondrocytes (rNSChs) and assays for cytotoxicity, proteoglycan (PG) synthesis, and PG turnover were carried out. The efficacious concentration of Decoy determined from the rNSChs was then applied to human nasal septal cartilage (hNSC) in vitro and analyzed for PG turnover, the levels of inflammatory markers, and catabolic enzymes in explant-conditioned culture medium. Results: Over the range of Decoy conditions and concentrations, no inhibition of PG synthesis or cytotoxicity was observed. Decoy at 10 μM effectively inhibited PG degradation in the hNSC explant, prolonging PG half-life by 63% and decreasing matrix metalloprotease 3 (MMP-3) by 70.7% (p = 0.027). Conclusions: Decoy may be considered a novel chondroprotective therapeutic agent in cartilage transplantation due to its ability to inhibit cartilage degradation due to inflammation cytokines. Full article

Septal cartilage defects and tympanic membrane perforations are some of the main challenging clinical problems in modern ENT (Ear, Nose and Throat) surgery. Polymer films based on biocompatible and biodegradable polymers seem to represent prospective materials for surgical reconstruction of such defects. In this study, we present the results of pilot in vivo experiments of the biocompatibility and biodegradability of bilayer films obtained via the casting method from hyaluronic acid (MW = 1300 kDa) and chitosan (500 and 900 kDa) polymer solutions. The total toxicity, pro-inflammatory activity, biodegradation rate and proliferative potential of the connective tissue of the dermis in the implantation area were evaluated on days 7, 14, 30 and 50 after the implantation. The studied samples demonstrated negligible overall acute and chronic toxicity. The influence of the preparation technique as well as the effect of chitosan’s MW on the biodegradation rate are also demonstrated. These bilayer polymer films can be recommended for ENT surgery, in particular for the reconstruction of the nasal septum and tympanic membrane. Full article

Objective: This study aims to evaluate the feasibility of visualizing nasal cartilage using deep-learning-based reconstruction (DLR) fast spin-echo (FSE) imaging in comparison to three-dimensional fast spoiled gradient-echo (3D FSPGR) images. Materials and Methods: This retrospective study included 190 set images of 38 participants, including axial T1- and T2-weighted FSE images using DLR (T1WI_DL and T2WI_DL, belong to FSE_DL) and without using DLR (T1WI_O and T2WI_O, belong to FSE_O) and 3D FSPGR images. Subjective evaluation (overall image quality, noise, contrast, artifacts, and identification of anatomical structures) was independently conducted by two radiologists. Objective evaluation including signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) was conducted using manual region-of-interest (ROI)-based analysis. Coefficient of variation (CV) and Bland–Altman plots were used to demonstrate the intra-rater repeatability of measurements for cartilage thickness on five different images. Results: Both qualitative and quantitative results confirmed superior FSE_DL to 3D FSPGR images (both p < 0.05), improving the diagnosis confidence of the observers. Lower lateral cartilage (LLC), upper lateral cartilage (ULC), and septal cartilage (SP) were relatively well delineated on the T2WI_DL, while 3D FSPGR showed poorly on the septal cartilage. For the repeatability of cartilage thickness measurements, T2WI_DL showed the highest intra-observer (%CV = 8.7% for SP, 9.5% for ULC, and 9.7% for LLC) agreements. In addition, the acquisition time for T1WI_DL and T2WI_DL was respectively reduced by 14.2% to 29% compared to 3D FSPGR (both p < 0.05). Conclusions: Two-dimensional equivalent-thin-slice T1- and T2-weighted images using DLR showed better image quality and shorter scan time than 3D FSPGR and conventional construction images in nasal cartilages. The anatomical details were preserved without losing clinical performance on diagnosis and prognosis, especially for pre-rhinoplasty planning. Full article

The nasal septal cartilage plays an important role in preventing the collapse of the nasal bones and maintaining the appearance of the nose. In the context of inherent difficulties regarding septal cartilage repair and the shortage of cartilage graft resources for regeneration, tissue engineering, especially the in situ strategy based on scaffolds, has become a new prospect and become one of the most promising approaches. Given that it is difficult for chondrocytes to achieve directional migration and secrete matrix components to participate in tissue repair after cartilage injury, cartilage progenitor cells (CPCs), with great migratory ability and stem cell characteristics, have caught the attention of researchers and brought hope for nasal septal cartilage in situ regeneration. In this review, we first summarized the distribution, characteristics, isolation, and culture methods of nasal septal CPCs. Subsequently, we described the roles of migratory CPCs in cartilage regeneration. Finally, we reviewed the existing studies on CPCs-based cartilage tissue engineering and summarized the strategies for promoting the migration and chondrogenesis of CPCs so as to provide ideas for achieving nasal septal cartilage in situ regeneration. Full article

Septoplasty is a widely used method in treating deviated septum. Although it is successfully implemented, there are problems with excessive bleeding, septal perforation, or infections. The use of anatomically shaped implants could help overcome these problems. This paper focuses on assessing the possibility of the usage of a nasal septum cartilage implant 3D printed from various market-available filaments. Five different types of laments were used, two of which claim to be suitable for medical use. A combination of modeling, mechanical (bending, compression), structural (FTIR), thermal (DSC, MFR), surface (contact angle), microscopic (optical), degradation (2 M HCl, 5 M NaOH, and 0.01 M PBS), printability, and cell viability (MTT) analyses allowed us to assess the suitability of materials for manufacturing implants. Bioflex had the most applicable properties among the tested materials, but despite the overall good performance, cell viability studies showed toxicity of the material in MTT test. The results of the study show that selected filaments were not suitable for nasal cartilage implants. The poor cell viability of Bioflex could be improved by surface modification. Further research on biocompatible elastic materials for 3D printing is needed either by the synthesis of new materials or by modifying existing ones. Full article

Background: We evaluated the efficacy of Cord Blood Platelet Gel (CBPG) in the regenerative reconstruction of the nasal septal tissue of a preterm infant undergoing non-invasive ventilation. Methods: A CBPC treatment was used to enhance the regeneration of the nasal septum of a premature patient in an experimental way, evaluating the efficacy described in the literature (selective bibliographic search in PubMed) of the use of blood products for non-transfusion purposes. Results: A partial but satisfactory regeneration of the patient’s nasal septum was observed. Using the free NIH Image J online software, we were able to calculate the regenerated surface (about 83% of the destroyed cartilage). Conclusions: The use of platelet gel has been a promising alternative to surgical treatment in patients with severe damage to the nasal septum. Full article

The surgery outcomes after fixing nasal airway obstruction (NAO) are sometimes not satisfactory in improving ventilations of airflow. A case study is presented in this paper with computational fluid dynamics applied to determine the key factors for successful septoplasty plans for a patient with a deviated nasal septum. Specifically, airflow, as well as particle transport and deposition were predicted in a pre-surgery nasal cavity model reconstructed from patient-specific Computer Tomography (CT) images and two post-surgery nasal cavity models (i.e., VS1 and VS2) with different virtual surgery plans A and B. Plan A corrected the deviated septal cartilage, the perpendicular plate of the ethmoid bone, vomer, and nasal crest of the maxilla. Plan B further corrected the obstruction in the nasal vestibule and caudal nasal septal deviation based on Plan A. Simulations were performed in the three nose-to-throat airway models to compare the airflow velocity distributions and local particle depositions. Numerical results indicate that the VS2 model has a better improvement in airflow allocation between the two sides than the VS1 model. In addition, the deposition fractions in the VS2 model are lower than that in both the original and VS1 models, up to 25.32%. The better surgical plan (i.e., Plan B) reduces the particle deposition on the convex side, but slightly increases the deposition on the concave side. However, the overall deposition in the nasal cavity is reduced. Full article

Previous anatomical studies have shown different functional zones in human nasal septal cartilage (NC). These zones differ in respect to histological architecture and biochemical composition. The aim of this study was to investigate the influence of these zones on the fate of stem cells from a regenerative perspective. Therefore, decellularized porcine septal cartilage was prepared and subjected to histological assessment to demonstrate its equivalence to human cartilage. Decellularized porcine NC (DPNC) exposed distinct surfaces depending on two different histological zones: the outer surface (OS), which is equivalent to the superficial zone, and the inner surface (IS), which is equivalent to the central zone. Human adipose tissue-derived stem cells (ASCs) were isolated from the abdominal fat tissue of five female patients and were seeded on the IS and OS of DPNC, respectively. Cell seeding efficiency (CSE), vitality, proliferation, migration, the production of sulfated glycosaminoglycans (sGAG) and chondrogenic differentiation capacity were evaluated by histological staining (DAPI, Phalloidin, Live-Dead), biochemical assays (alamarBlue^®, PicoGreen^®, DMMB) and the quantification of gene expression (qPCR). Results show that cell vitality and CSE were not influenced by DPNC zones. ASCs, however, showed a significantly higher proliferation and elevated expression of early chondrogenic differentiation, as well as fibrocartilage markers, on the OS. On the contrary, there was a significantly higher upregulation of hypertrophy marker MMP13 (p < 0.0001) and GAG production (p = 0.0105) on the IS, whereas cell invasion into the three-dimensional DPNC was higher in comparison to the OS. We conclude that the zonal-dependent distinct architecture and composition of NC modulates activities of ASCs seeded on DPNC. These findings might be used for engineering of cartilage substitutes needed in facial reconstructive surgery that yield an equivalent histological and functional structure, such as native NC. Full article

Care for patients with cleft lip and palate is best managed by a craniofacial team consisting of a variety of specialists, including surgeons, who are generally plastic surgeons or otolaryngologists trained in the United States. The goal of this study was to compare the surgical approaches and management algorithms of cleft lip, cleft palate, and nasal reconstruction between plastic surgeons and otolaryngologists. We performed a retrospective analysis of the American College of Surgeons’ National Surgical Quality Improvement Program Pediatric database between 2012 and 2014 to identify patients undergoing primary repair of cleft lip, cleft palate, and associated rhinoplasty. Two cohorts based on primary specialty, plastic surgeons and otolaryng-ologists, were compared in relation to patient characteristics, 30-day postoperative outcomes, procedure type, and intraoperative variables. Plastic surgeons performed the majority of surgical repairs, with 85.5% (n = 1472) of cleft lip, 79.3% (n = 2179) of cleft palate, and 87.9% (n = 465) of rhinoplasty procedures. There was no difference in the age of primary cleft lip repair or rhinoplasty. However, plastic surgeons performed primary cleft palate repair earlier than otolaryngologists (p = 0.03). Procedure type varied between the specialties. In rhinoplasty, otolaryngologists were more likely to use septal or ear cartilage, whereas plastic surgeons preferred rib cartilage. Results were similar, with no statistically significant difference in terms of mortality, reoperation, readmission, or complications. Significant variation exists in the treatment of cleft lip and palate based on specialty service with regard to procedure timing and type. However, short-term rates of mortality, wound occurrence, reoperation, readmission, and surgical or medical complications remain similar. Full article