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Comparative Efficacy of Diced Cartilage Versus Diced Bone for Correcting Dorsal Nasal Irregularities: a Pilot
Saeed Shirafkan1, Ershad Hemmati1, Meghdad Khanian Mehmandoost Sofla2
1Assistant Professor, Department of Oral and Maxillofacial surgery, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Background:
Rhinoplasty is among the most technically demanding procedures in plastic surgery. Aesthetic deformities of the nasal dorsum substantially affect facial appearance. Various graft materials have been used to correct these irregularities. This study aimed to compare the short-term efficacy of diced cartilage and diced bone grafts in correcting dorsal nasal irregularities.
Methods:
This pilot randomized clinical trial included 60 patients undergoing primary rhinoplasty. The patients were randomly assigned into two equal groups using permuted-block randomization with a block size of 4. In the first group, diced septal cartilage was used for dorsal augmentation; in the second group, diced bone obtained from hump resection and bony spurs along the septal floor was used. Follow-up assessments were performed at one week, one month and three months postoperatively. Short-term efficacy was evaluated by palpation and photographic documentation. At three months, patient satisfaction with nasal appearance was measured using a 10-cm visual analog scale (VAS). All participants also completed the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS).
Results:
Patients' mean age was 26.98 ± 3.75 years. Of the 60 participants, 54 (90%) were women and six (10%) men. According to the surgeon's assessment, both graft types were effective in all cases during the three-month follow-up period. The mean VAS satisfaction score was 8.97 ± 1.77 overall, with mean scores of 8.97 ± 1.88 in the diced bone group and 9.00 ± 1.66 in the diced cartilage group. Aesthetic satisfaction was similar in the two groups, with no statistically significant difference (P = 0.879). For the nasal obstruction domain (items 1-4) and the aesthetic domain (items 5-10), most patients in both groups selected either "no problem" or "a very minor problem."
Conclusion:
Both diced cartilage and diced bone demonstrated satisfactory short-term outcomes for dorsal nasal augmentation, with no significant difference in patient satisfaction at three months. Longer follow-up is needed to assess their long-term stability and graft behavior.