Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-27T08:52:43.306Z Has data issue: false hasContentIssue false

Influence of the mode of preparation on the long-term efficacy of homologous costal cartilage implants

Published online by Cambridge University Press:  29 June 2007

P. Adlington
Affiliation:
From the Departments of ENT, Swansea
A. J. Anscombe
Affiliation:
From the Departments of Pathology, Swansea
J. J. Pmllips
Affiliation:
Bournemouth and the Department of ENT, Swansea.

Abstract

Devitalized homologous costal cartilage is widely employed as an implant in the management of the saddle nose. The tissue response induced by the implant is a combination of enveloping fibrosis and implant resorption, which will probably, ultimately, be complete. We have studied the balance between resorption and fibrosis, following different modes of cartilage preparation, in the mouse. Homologous costal cartilage was devitalized by four common methods—irradiation, formalin, glutaraldehyde and alochol. Segments of this cartilage were inserted at separate sites in the subcutaneous plain of the tail. These implants were harvested after one year for histology. Variations in the mode of cartilage devitalization, while inducing variations in the degree of the tissue response, did not influence the balance between fibrosis and resorption. Thus the long term maintenance of tissue bulk following homologous cartilage implantation is not influenced by the mode of preparation. Evidence suggests that the ultimate cosmetic results of autologous and homologous costal cartilage implantation would be much the same, and the use of homologous cartilage must be justified on other grounds.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adlington, P., Anscombe, A. J., Joshi, J. B. (1989) Influence of the mode of preparation on the distortion of homologous costal cartilage implants. Journal of Laryngology and Otology, 103: 572576.CrossRefGoogle ScholarPubMed
Alichniewicz, A., Bardach, J., Kozlowski, H., Pruszczynski, M. (1964) Research on grafted conserved homogenous cartilage. Acta Chirurgica Plastica, 6: 229234.Google Scholar
Babin, R. W., Ryu, J. H., Gantz, B. J., Maynard, J. L. A. (1982) Survival of implanted irradiated cartilage. Otolaryngology—Head and Neck Surgery, 90: 7580.CrossRefGoogle ScholarPubMed
Bloom, S. M. (1960) The problem of implants in rhinoplasty. Archives of Otolaryngology, 71: 778787.CrossRefGoogle ScholarPubMed
Braley, S. (1973) The silicones—their uses in nose, chin and ear. In Symposium on aesthetic surgery of nose and chin, Vol. 6, ch. 32. (Masters, F. W., Lewis, J. R., eds.) C. V. Mosby: St Louis.Google Scholar
Brown, J. B. (1940) Preserved and fresh homotransplants of cartilage. Surgery, Gynaecology and Obstetrics, 70: 10791982.Google Scholar
Brown, B. L., Neel, B., Kern, E. B. (1979) Implants of supramid, proplast, plastipore and silastic. Archives of Otolaryngology, 105: 605609.CrossRefGoogle ScholarPubMed
Bull, T. R. (1987) Rhinoplasty. In Scott-Brown's Otolaryngology. Fifth ed. Vol. 4, Rhinology (Bull, T. R., Mackay, I. S., and Kerr, A. G., eds.) Butterworth: London, p. 260261.Google Scholar
Dingman, R. O., Grabb, W. C. (1961) Costal cartilage homografts preserved by irradiation. Plastic and Reconstructive Surgery, 28: 562566.CrossRefGoogle ScholarPubMed
Donald, P. J., Col, A. (1982) Cartilage implantation in head and neck surgery. Report on a national survey. Otolaryngology—Head and Neck Surgery, 90: 8589.CrossRefGoogle ScholarPubMed
Donald, P. J. (1986) Cartilage grafting in facial reconstruction, with special consideration of irradiated grafts. Laryngoscope, 96: 786807.CrossRefGoogle ScholarPubMed
Farrior, R. T. (1966) Implant materials in the restoration of facial contour. Laryngoscope, 76: 934954.CrossRefGoogle ScholarPubMed
Gibson, T., Davis, W. B., Curran, R. C. (1958) The long term survival of cartilage homografts in man. British Journal of Plastic Surgery, 11: 177186.CrossRefGoogle Scholar
Gibson, T., Davis, W. B., Gillies, H. D. (1959) The encapsulation of preserved cartilage grafts with prolonged survival. British Journal of Plastic Surgery, 12: 2228.CrossRefGoogle Scholar
Glasscock, M. F. III, Jackson, C. G., Know, G. W. (1988) Can AIDS and Creutzfeldft-Jacob disease be transmitted in otological grafts? Archives of Otolaryngology, 113: 12521255.CrossRefGoogle Scholar
Ham, K. S., Chung, S. C., Lee, S. H. (1983) Complications of oriental augmentation rhinoplasty. Annals of the Academy of Medicine, 12, No. 2 Supplement: 460462.Google ScholarPubMed
Hellmich, S. (1974) Der ein fluss unter schiedlicher konservierung methoden auf die biologische qualitat von kuorpel implantaten. Laryngologie und Rhinologie, 53: 711717.Google Scholar
Hellmich, S. (1979) Implants for nasal deformity. Meeting of the Joseph Society, Wurzburg.Google Scholar
Ironside, W. M. S. (1982) Biological materials used in reconstruction of the ear: their preservation and banking. Journal of the Royal Society of Medicine, 75: 691698.CrossRefGoogle ScholarPubMed
Lefkovits, G. (1990) Irradiated homologous costal cartilage for augmentation rhinoplasty. Annals of Plastic Surgery, 25: 317327.CrossRefGoogle ScholarPubMed
Limberg, A. A. (1961) The use of diced cartilage by injection with a needle. Plastic and Reconstructive Surgery, 28: 523526.CrossRefGoogle ScholarPubMed
Linberg, J. V., Anderson, R. L., Edwards, J. J., Panje, W. R., Bardach, J. (1980) Preserved irradiated homologous cartilage for orbital reconstruction. Ophthalmic Surgery, 11: 457462.Google ScholarPubMed
Marquit, B. (1967) Radiated homogenous cartilage in rhinoplasty. Archives of Otolaryngology—Head and Neck Surgery, 85: 7880.CrossRefGoogle ScholarPubMed
McGlynn, M. J., Sharpe, D. T. (1981) Cialit preserved homograft cartilage in nasal augmentation: a long term review. British Journal of Plastic Surgery, 34: 5357.Google ScholarPubMed
Medawar, P. B. (1957) Immunity of homologous grafted skin; fate of skin homografts transplanted to brain, to subcutaneous tissue and to the anterior chamber of the eye. British Journal of Experimental Pathology, 29: 5869.Google Scholar
Mikhelson, N. M. (1962) Homogenous cartilage in maxillofacial surgery. Ada Chirurgica Plastica, 4.3: 192196.Google Scholar
Mowlem, R. (1941) Bone and cartilage transplants, their use and behaviour. British Journal of Surgery, 29: 182193.CrossRefGoogle Scholar
Muhlbauer, W. D., Schmidt-Tintemann, U., Glaser, M. (1971) Long term behaviour of preserved homologous rib cartilage in the correction of saddle nose deformity. British Journal of Plastic Surgery, 24: 325333.CrossRefGoogle ScholarPubMed
Rasi, H. (1959) The fate of preserved human cartilage. Plastic and Reconstructive Surgery, 28: 562566.Google Scholar
Reck, R., Mika, H., Sonntag, W. (1978) Allogenic implants of the nasal dorsum: clinical and experimental studies in animals. Rhinology, 17: 121124.Google Scholar
Schuller, D. E., Bardach, J., Krause, C. J. (1977) Irradiated homologous costal cartilage for facial contour restoration. Archives of Otolaryngology, 103: 1215.CrossRefGoogle ScholarPubMed
Spire, B., Dormont, D., Barre-Sinoussi, R., Montagnier, L., Chermann, J. C. (1985) Inactivation of lymphadenopathy—associated virus by heat, gamma rays and ultraviolet light. The Lancet, 188189. (January 26).CrossRefGoogle ScholarPubMed
Stoksted, P., Ladefoged, C. (1986) Crushed cartilage in nasal reconstruction. Journal of Laryngology and Otology, 100: 897906.CrossRefGoogle ScholarPubMed
Welling, D., Maves, M. D., Schuller, D. E., Bardach, J. (1988) Irradiated homologous cartilage grafts. Archives of Otolaryngology Head and Neck Surgery, 114: 291295.CrossRefGoogle ScholarPubMed
Wilmes, E., Gurtler, L., Wolf, H. (1987) Zur ubutrag barheit von HIV-infektionen durch allogens transplantate. Laryngology, Rhinology and Otology, 66: 332334.CrossRefGoogle Scholar
Woodruff, M. F. A. (1957) Cellular and humoral factors in the immunity to skin homografts: experiments with a porous membrane. Annals of the New York Academy of Sciences, 64: 10141026.CrossRefGoogle ScholarPubMed