Efficacy of Autologous vs. Homologous Costal Cartilage Grafts in Dorsal Augmentation Rhinoplasty: A Systematic Review and Meta-analysis

Author(s):

Omair Hussain Alhussain*, Ghadah Omair Alhussain, Abdullah Abdulmajeed Rajkhan, Ali Jaber Suhluli, Shahd Jamil Alharbi, Ahmad Abubakr Sherwani, Abdullah Fahad Alzamil and Mazen Abdullah Mohammed

Background: Even though septal cartilage is an excellent source if available, additional material is often required for revision. Costal and auricular cartilages are well-accepted sources and thought to be superior to alloplastic implants because of the lower chance of infection and extrusion. Due to the larger quantity of cartilage available with costal cartilage in comparison with auricular cartilage, costal cartilage is often the graft of choice in augmentation rhinoplasty. Aim: This work aims to determine the efficacy and safety of Irradiated Homologous Costal Cartilage (IHCC) versus Autologous Costal Cartilage (ACC) grafts in dorsal augmentation rhinoplasty patients. Materials and Methods: A systematic search was performed over different medical databases to identify Otolaryngology studies, which studied the outcome of the IHCC group versus the ACC group of dorsal augmentation rhinoplasty patients. Using the meta-analysis process, either with fixed or random-effects models, we conducted a meta-analysis on the warping rate as a primary outcome, and resorption and revision surgery rates as a secondary outcome. Results: Seven studies were identified involving 634 patients, with 302 patients in the IHCC group, and 322 patients in the ACC group. The meta-analysis process revealed a highly significant decrease in the warping rate in the IHCC group compared to the ACC group (p=0.002). We found a non-significant difference in resorption rate and revision surgery rates in the IHCC group compared to the ACC group (p>0.05). Conclusion: To conclude, no significant difference between autologous and homologous costal cartilage grafts, including resorption, or revisions, in patients undergoing dorsal augmentation rhinoplasty, but IHCC was safer approach concerning warping rate.