Cartilaginous behavior in nasal surgery: a comparative observational study

Cartilaginous autografts, either from the ribs, auricular concha, nasal septum, or even the alar cartilages, are some of the most widely used materials in nasal surgery. Nevertheless, no comparative study exists on these four cartilages in which their physicoelastic properties are analyzed based on their histological architecture and their function within the organism. The studies that do exist on structure and classification of cartilages differ widely. In this study, cartilage specimens obtained from the nasal septum, rib, auricular pavilion, and alar of 7 fresh cadavers were analyzed. They were subjected to special tincturing to be able to histologically observe their architecture, cellularity, intercellular substance, the relationship between cellularity and intercellular substance, the primary components of the matrix, and the distribution of fibers. Many similarities were found among the septal, costal, and alar cartilages. All three exhibit little cellularity and much intercellular substance. The intercellular substance is made up of homogeneously distributed collagen fibers. Auricular cartilage has many cells and little intercellular substance, being made up of irregularly distributed elastic fibers. On the basis of these findings, we propose a simpler classification and make recommendations for the use of these four cartilages in nasal surgery.