The rate of warping in irradiated and nonirradiated homograft rib cartilage: A controlled comparison and clinical implications

Irradiated homograft costal cartilage reportedly warps less than autologous cartilage based on clinical observation; however, no controlled, experimental studies on the warping characteristics of irradiated homograft costal cartilage have been done. Fresh cadaver costal cartilage (ribs 5 through 8) was prepared and irradiated using a standardized technique. A specially designed cartilage-cutting device was used to cut the cartilage into a reproducible size. The irradiated (n = 23) and nonirradiated (n = 20) groups were incubated in vitro and assessed over a 4-week period. There was no significant difference in warping between the irradiated and nonirradiated groups (p = 0.1). The centrally cut pieces of cartilage in each group warped less than peripherally cut blocks in each group. Peripherally cut pieces of both the irradiated and nonirradiated groups warped at a faster rate compared with the nonirradiated groups. All cartilage exhibited continued warping over the 4-week study period. We concluded that there was no difference in warping characteristics between irradiated and nonirradiated homograft rib cartilage. Furthermore, unlike previous studies, cartilage grafts continued warping over time for at least 4 weeks, and this phenomenon may be extrapolated as a causative factor in delayed postoperative nasal deviation after rhinoplasty and nasal reconstruction where rib grafts are used.