Абстракт

Objectives: The primary objective of this presentation is to comprehensively compare the clinical efficacy, biomechanical properties, and safety profiles of autologous, cadaveric, and equine costal cartilage in Asian rhinoplasty. By evaluating parameters such as warping risk, resorption rates, and donor site morbidity, we aim to establish a strategic, evidence-based guideline for selecting the optimal structural grafting material tailored to specific surgical indications. Introduction: Asian rhinoplasty frequently requires robust structural support to overcome thick soft tissue envelopes and weak native cartilaginous frameworks. While autologous costal cartilage is the gold standard for achieving maximal tip projection, donor site morbidity remains a significant deterrent. Consequently, homologous (cadaveric) and xenograft (equine) alternatives have gained popularity. Understanding the distinct biomechanical behaviors of each material is crucial for optimizing outcomes. Materials / method: A comparative analysis was conducted evaluating three categories of costal cartilage: Autologous (ACC), Cadaveric including Irradiated (IHCC) and Fresh Frozen (FFRG), and Equine xenografts. Materials were assessed across multiple clinical parameters: inherent biomechanical properties (flexural strength), intraoperative handling, postoperative warping risk, long-term resorption rates, complication profiles (infection, immune rejection), and the presence of donor site morbidity. Results: ACC provides maximal support but carries donor morbidity and high warping risk. IHCC demonstrated excellent outcomes as a reliable off-the-shelf option, showing absolutely no immune rejection and negligible resorption in our series. Equine cartilage mimics septal cartilage's flexural strength, offering the lowest warping risk, zero rejection, and high cost-effectiveness. However, it is prone to fracture under excessive suture tension, requiring meticulous handling during diverse structural applications. Conclusion: Material selection in Asian rhinoplasty must be customized. ACC is the ultimate choice for severe revisions requiring maximal support. IHCC provides an outstanding, stable alternative with minimal resorption and no rejection. Equine cartilage, while requiring delicate suturing to prevent fracture, emerges as a highly cost-effective, safe, non-immunogenic, and low-warping xenograft suitable for diverse structural applications. Understanding these profiles ensures predictable surgical results.