Effects of hyaluronic acid on the bone healing after lateral osteotomy: an experimental animal model

Postoperative comfort of the patients undergoing rhinoplasty might be poor because of edema and ecchymosis caused by lateral osteotomy. In this animal experiment, we aimed at performing a quantitative assessment of effects of hyaluronic acid usage on healing process of lateral osteotomy.

Fourteen New Zealand rabbits with a weight of 2000-2500 kg and an age of 8-12 weeks were included. Under anesthesia, nasal dorsums were exposed with midline incision and lateral osteotomies on both sides were performed using a 2 mm chisel. A hyaluronic acid-based mesh (Hyalonect^®) (1 × 1 cm) was embedded on the left osteotomy areas of all rabbits. Right osteotomy areas were left blank as control group. Collagen density and capillary development were quantitatively compared.

Convergence of fracture lines was observed in 6 (60%) of 10 samples from Hyalonect^® group, while was observed in 4 (40%) of 10 samples from control group. Although a higher rate of convergence was seen in the Hyalonect^® group (60% vs 40%), the difference was not statistically significant (p = 0.5). Median collagen score was 2 (1-3) in the Hyalonect^® group and 1 (1-2) in the control group. Median capillary count value was 4 (1-23) in the Hyalonect^® group and 3 (1-17) in the control group. Both collagen score and capillary count values were significantly greater in the in the Hyalonect^® group compared with the control group (p = 0.023 and p = 0.019, respectively).

The effects of hyaluronic acid-based meshes on the bone healing process of the lateral osteotomy area might be investigated furthermore, on more comprehensive studies, as a material facilitating collagen organization and capillary development.