Surgical and Patient-Reported Outcomes of Fresh Frozen Homologous Costal Cartilage in Primary, Revision, and Functional Rhinoplasty.

Abstract

Modern techniques in structure rhinoplasty require cartilage for grafting. The optimal source of this cartilage is debated. Fresh frozen homologous costal cartilage (FFHCC) grafts are a promising source of cartilage; further investigation is needed into efficacy and safety. The purpose of this article is to review an extensive rhinoplasty experience using FFHCC in cosmetic and functional applications. Retrospective review of one surgeon's experience performing 123 rhinoplasties using FFHCC grafts was performed. Outcomes were postoperative complications and patient-reported outcome measures (PROMs). The average follow-up time was 11.0 months (range, 1 to 44 months). Infection was noted in 3 patients (2.4%). Resorption was noted in 1 patient (0.8%). Analysis of PROMs was at last follow-up. Nasal Obstruction Symptom Evaluation scores showed mean improvement of -7.9 ± 8.1 ( P < 0.001). Twenty-Two Item Sinonasal Outcomes Test scores showed mean improvement of -18.9 ± 17.5 ( P < 0.001). Epworth Sleepiness Scale scores showed mean improvement of -4.8 ± 5.8 ( P < 0.001). The Standardized Cosmesis and Health Nasal Outcomes Survey revealed total, functional, and cosmetic scores with a mean improvement of -13.5 ± 11.1 ( P < 0.001), -5.1 ± 5.9 ( P < 0.001), -8.2 ± 7.3 ( P < 0.001). FFHCC grafts provide a convenient and economical off-the-shelf solution for rhinoplasty. The findings of this study support the safety of FFHCC use and demonstrate positive improvement in PROMs across multiple domains.