The use of diced cartilage grafts in nasal aesthetic and reconstructive surgeries: Clinical and radiological evaluation

Background: Rhinoplasty is considered to be one of the most fascinating and challenging operation for any plastic surgeon (1). The aim of using grafts for the nasal dorsum is either to augment or to camouflage minor irregularities (4, 5). Grafts on the nasal dorsum are easy to be visible. For this purpose, it is better to use diced cartilage (DC) grafts either free to smoothen the nasal dorsum or wrapped in the fascia (DC-F) to augment it (6, 7). The main goal of this study is to assess the impact of the use of DC grafts on the aesthetic outcome as well as its role in the reconstruction of the nasal dorsum. Evaluation is done clinically using the nasal obstruction symptom evaluation score and rhinoplasty outcome evaluation score, (8, 9) as well as radiologically using ultrasound measurement of the thickness of the DC-F graft during a follow-up period of 4 weeks, 3 months, and 6 months' intervals. Patients and Methods: This prospective study was conducted between January 2022 and March 2024. Twenty patients were included and planned for using DC whether free or wrapped in fascia. Results: All patients (14 females and six males) underwent open rhinoplasty. DC-F was used in 12 (60%) cases, while free DC in 8 (40%) cases. A statistically significant difference between preoperative and postoperative nasal obstruction symptom evaluation scores was found ( P<0.00] ). The mean postoperative rhinoplasty outcome evaluation score was 88.73. Conclusion: It was found that the DC-F was an effective technique in nasal dorsum augmentation with guaranteed longterm results and with no risk of graft visibility. Meanwhile, a free DC graft is a versatile tool in camouflaging minor irregularities on the nasal dorsum as well as the nasal tip.