Surgical and Patient-Reported Outcomes of Fresh Frozen Homologous Costal Cartilage in Primary, Revision, and Functional Rhinoplasty

Overview

Structural rhinoplasty needs cartilage, and where the patient's septum and ears are insufficient the choice is the patient's own rib or a donor's. Barrera reviewed 123 cases in his practice using fresh-frozen homologous costal cartilage (FFHCC) across cosmetic, revision and functional indications, recording complications and patient-reported outcome measures at last follow-up.

Sections of note

• Mean follow-up 11.0 months (range 1 to 44).
• Infection in 3 patients (2.4%); resorption in 1 (0.8%).
• NOSE improved by a mean of 7.9 points; SNOT-22 by 18.9; Epworth Sleepiness Scale by 4.8 (all P < 0.001).
• SCHNOS total improved by 13.5, functional by 5.1, cosmetic by 8.2 (all P < 0.001).
• The authors describe FFHCC as "a convenient and economical off-the-shelf solution."

What it means for a patient

• Donor rib cartilage avoided a chest incision and, in this series, had low infection and resorption rates.
• Breathing, sinus symptoms and daytime sleepiness all improved, suggesting many cases were functional.
• Follow-up averaged under a year, and resorption can appear later.

Why this paper matters

It is a mid-sized single-surgeon series supporting fresh-frozen (non-irradiated) donor cartilage. Limits: retrospective, one surgeon, no autologous comparison group, short and variable follow-up.

Terms

• Fresh-frozen homologous costal cartilage (FFHCC): donor rib cartilage preserved by freezing rather than irradiation.
• Resorption: loss of graft volume as the body absorbs it.
• Epworth Sleepiness Scale: a questionnaire on daytime sleepiness, often used in sleep-disordered breathing.
• SNOT-22: a 22-item sinus and nasal symptom score.
• Patient-reported outcome measure (PROM): a validated questionnaire completed by the patient.