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Original Investigation |

Age-Related Histologic Changes in Human Nasal Cartilage

Judy W. Lee, MD1; Jonathan McHugh, MD2; Jennifer C. Kim, MD1; Shan R. Baker, MD1; Jeffrey S. Moyer, MD1
[+] Author Affiliations
1Center for Facial Cosmetic Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor
2Department of Pathology, University of Michigan, Ann Arbor
JAMA Facial Plast Surg. 2013;15(4):256-262. doi:10.1001/jamafacial.2013.825.
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Importance  Understanding age-related changes is important when considering cartilage-based implants or grafts during rhinoplasty and nasal reconstructive surgery.

Objective  To characterize the cellular and architectural changes in human nasal cartilage with aging.

Design  Laboratory study.

Participants  Nasal septal cartilage was harvested from 50 consecutive patients undergoing septoplasty, rhinoplasty, or septorhinoplasty.

Intervention  Cartilage specimens were stained with hematoxylin-eosin (H&E) and safranin O for cartilage.

Main Outcome Measures  A modified Mankin histologic grading scale was used to analyze each cartilage sample for H&E findings and safranin O staining. Higher H&E scores indicated more degenerative changes, while higher safranin O scores indicated reductions in proteoglycan content within the cartilage matrix, representing decreased active chondrocyte activity. Correlation between H&E and safranin O scores and patient age was determined.

Results  There was positive correlation between safranin O staining scores and age, with higher scores seen with advancing age (P = .01). A linear regression best-fit equation was determined to calculate a potential safranin O staining score for a given age.

Conclusions and Relevance  We have quantitatively determined that advancing age is positively correlated with reductions in cartilage proteoglycan content and active cartilage growth. This finding not only enhances our current understanding of the natural changes that occur in cartilage with aging but may also affect surgical decision making when cartilage grafting is considered during functional, reconstructive, and aesthetic rhinoplasty.

Level of Evidence  NR.

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Figures

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Figure 1.
Hematoxylin-Eosin Staining

Hematoxylin-eosin staining in a 79-year-old patient reveals chondrocyte hypercellularity associated with cartilage injury (original magnification ×100).

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Figure 2.
Hematoxylin-Eosin Staining

Hematoxylin-eosin staining in an 18-year-old patient with normal chondrocyte cellularity (original magnification ×100).

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Figure 3.
Safranin O Staining

Safranin O staining in an 18-year-old patient with intense red staining due to high proteoglycan content (original magnification ×100).

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Figure 4.
Safranin O Staining

Safranin O staining in a 79-year-old patient with marked reduction in staining (original magnification ×100).

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Figure 5.
Hematoxylin-Eosin Score

Hematoxylin-eosin staining scores as a function of donor age.

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Figure 6.
Safranin O Score

Safranin O staining scores as a function of donor age.

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Figure 7.
Hematoxylin-Eosin Score

Hematoxylin-eosin staining scores for female patients as a function of donor age.

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Figure 8.
Hematoxylin-Eosin Score

Hematoxylin-eosin staining scores for male patients as a function of donor age.

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Figure 9.
Safranin O Score

Safranin O staining scores for female patients as a function of donor age.

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Figure 10.
Safranin O Score

Safranin O staining scores for male patients as a function of donor age,

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