Rhinoplasty: Complications Associated With Using Rib Cartilage

Hong Ryul Jin, MD Professor and Chair Department of Otorhinolaryngology-HNS Seoul National University Boramae Medical Center, Seoul, Korea MedicalResearch.com Interview with:
Hong Ryul Jin, MD

Professor and Chair
Department of Otorhinolaryngology-HNS
Seoul National University
Boramae Medical Center, Seoul, Korea

Medical Research: What is the background for this study? What are the main findings?

Response: Although autologous rib cartilage is a useful graft material for rhinoplasty, surgeons sometimes encounter unpleasant complication such as warping or donor-site morbidity. These complications are not infrequent, but there has been no systematic review with regarding this matter. For evidence-based practice, we aimed to assess the long-term safety of using rib cartilage by means of meta-analysis.

By reviewing the 10 selected, eligible articles after extensive screening, we found that rates of warping, resorption, infection, and displacement were 3.1, 0.2, 0.6, and 0.4%, respectively. Hypertrophic scar at chest was found in 5.5%, with highest report of 23.8%. Warping and hypertrophic chest scarring showed relatively higher rates, warranting a surgeon’s attention

Medical Research: What should clinicians and patients take away from your report?

Response: From the result, autologous rib cartilage is considered as one of the safest graft materials that is resistant to infection and absorption. We hope surgeons who are using rib cartilage for rhinoplasty aware of the occurrence of warping and chest scar and do their best avoid them. However, even with this warning to surgeons, the reported incidence is within an acceptable range for the patients.

Medical Research: What recommendations do you have for futue research as a result of this study?

Response: Because a limited number of studies and patients were eligible, and consistent definitions of complications were lacking in this meta-analysis, future studies with a larger series of patients and objective outcome measurements are needed to obtain more reliable results. In addition, research for biomechanical properties and their changes after implantation of rib cartilage will elucidate the aforementioned concerns in rhinoplasty.

Citation:

Complications Associated With Autologous Rib Cartilage Use in Rhinoplasty: A Meta-analysis

Wee J, Park M, Oh S, Jin H. Complications Associated With Autologous Rib Cartilage Use in Rhinoplasty: A Meta-analysis. JAMA Facial Plast Surg. Published online November 27, 2014. doi:10.1001/jamafacial.2014.914.