Effect of Injectable Platelet-Rich Fibrin on Diced Cartilage's Viability in Rhinoplasty

Overview

Diced cartilage is widely used to smooth the bridge, but how much of it shrinks varies unpredictably. Platelet-rich fibrin is a concentrate made from the patient's own blood containing growth factors. This study tested whether mixing it with the diced cartilage reduces that shrinkage.

Sections of note

• 40 patients randomly divided into two groups by dorsal camouflage graft type: diced cartilage with injectable platelet-rich fibrin, and diced cartilage without it.
• Cartilage graft thickness was measured by linear superficial tissue ultrasound at postoperative week 1 and month 3 in both groups.
• Mean thickness loss between those points: 0.58 plus or minus 0.21 mm in the study group.
• Mean thickness loss in the control group: 0.82 plus or minus 0.35 mm.
• There was significant volume loss in the control group.
• The authors conclude the additive reduced resorption by increasing viability or helping the graft hold its form.
• They describe the combination as sticky cartilage, an easily applicable technique for camouflaging bridge irregularities.

What it means for a patient

• Both groups lost graft thickness; the additive reduced the loss by roughly 0.24 mm over three months.
• The material comes from the patient's own blood, drawn and spun at the time of surgery.
• Limits: 40 patients, two groups of 20, single center, follow-up only to 3 months, and thickness measured by ultrasound rather than graft survival directly.
• Three months is short for judging cartilage resorption, which continues over years.

Why this paper matters

Unpredictable shrinkage is the main drawback of diced cartilage grafting, and an autologous additive that reduces it would improve predictability without introducing foreign material. The randomized design with objective measurement is a strength. The short follow-up leaves long-term resorption unaddressed.

Terms

• Diced cartilage: Cartilage cut into very small pieces and used as a mass.
• Platelet-rich fibrin: A concentrate made from the patient's own blood, containing growth factors.
• Resorption: Gradual absorption and shrinkage of a graft by the body.
• Camouflage graft: Material placed to disguise an irregularity rather than to support structure.
• Superficial tissue ultrasound: Imaging with sound waves used to measure shallow tissue thickness.