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Editor's Correspondence |

Crushed Cartilage Grafts: Is Overcorrection Necessary?

Ozcan Cakmak, MD
Arch Facial Plast Surg. 2008;10(6):428. doi:10.1001/archfaci.10.6.428-a.
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I read the article by Ale de Souza et al1 with great interest. The authors concluded that crushed grafts had inferior results with lesser chondrocyte viability compared with noncrushed forms, and slight overcorrection was recommended during placement of crushed cartilage grafts. Based on our experimental and clinical findings, I believe the need of overcorrection is highly dependent on the level of crushing applied.

Conflicting information exists regarding the viability of the crushed autogenous cartilage grafts and the predictability of their clinical outcomes. Recently, we attempted to resolve these inconsistent results by assessing the influence of the degree of crushing on the rabbit auricular2 and human nasal septal3 cartilages, and the clinical outcome of crushed grafts in rhinoplasty.4 Our experimental studies2,3 showed that although significant or severe crushing reduced chondrocyte viability and proliferation, slight or moderate crushing enabled good chondrocyte viability and proliferation rates comparable with those of intact cartilage. Our recent clinical series4 confirmed findings from our previous studies2,3 that the degree of crushing applied is important for the resorption rates and long-term clinical outcome of crushed cartilage grafts used in rhinoplasty.

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