We read the article by Garg et al,1 titled “Chondrocyte Viability in Human Nasal Septum After Morselization,” with great interest. Garg et al1 evaluated the viability of different degrees of human crushed septal cartilages by viability analysis of cartilages using a Live/Dead assay (Molecular Probes Inc, Eugene, Oregon) in conjunction with confocal microscopy within 12 hours of explantation. They performed different degrees of crushing with a Cottle Crusher (model 523900; Karl Storz GmbH & Co, Tuttlingen, Germany), as defined by our group2- 6: slightly crushed, 1 hit of moderate force to soften the surface without reducing cartilage elastic strength; moderately crushed, 2 moderate-force hits to soften the surface and also reduce elastic strength; significantly crushed, 3 to 4 moderate-force hits, enough to cause the graft bending with gravity; and severely crushed, 5 to 6 forceful hits to totally destroy the integrity of the cartilage. As Garg et al1 stated, their results supported the findings of our group's previous studies2- 6 that aggressive morselization had reduced chondrocyte viability. They also noted that the degree of crushing produced was dependent on the surgeon and the crushing product or device.
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