The role of apoptosis in traumatic versus nontraumatic nasal septal cartilage.
BACKGROUND
Nasal surgery is occasionally performed to correct traumatic nasal deformity. Septal cartilage is the main tissue to be corrected and is a graft source when needed. A risk in engrafting with cartilage is the possibility of resorption as a result of either necrosis or apoptosis. The authors evaluated the rate of apoptosis in deviated and straight cartilage to investigate the cause of resorption of cartilage tissue.


METHODS
Twenty-five patients with traumatic nasal septum deviation (group I) and 13 patients with nontraumatic nasal septum deviation (group II) were prospectively enrolled. After correction of the deviation, two small samples of cartilage were harvested, one from the deviated site (group Ia or IIa) and the other from the straight site (group Ib or IIb), immediately frozen at -70 masculineC, and evaluated for apoptosis using DNA agarose gel electrophoresis.


RESULTS
Apoptosis was detected in 14 (56 percent) of the deviated and two (8 percent) of the straight cartilage samples in traumatic patients, whereas it was detected in only one deviated sample (7.7 percent) and none of the straight samples in nontraumatic patients. The apoptosis rates in group Ia were statistically significant when compared with groups Ib (p = 0.0007) and IIa (p = 0.0007).


CONCLUSIONS
The present study demonstrates that apoptosis occurs in traumatized nasal septal cartilage. Apoptosis might be the factor leading to cartilage resorption, weakness, and warping when used as a graft. Thus, cartilage grafting materials should be taken from the nontraumatized portion of the septum and should not be traumatized either during harvesting or before placement.
Görür
Kemal
K
Mersin, Turkey From the Departments of Otolaryngology, Biochemistry, and Plastic and Reconstructive Surgery, University of Mersin School of Medicine.
Polat
Gürbüz
G
Özcan
Cengiz
C
Arslan
Emrah
E
Vayisoğlu
Yusuf
Y
Öztürk
Özlem Görüroğlu
ÖG
Bağdatoğlu
Özlen
Ö
D000293:Adolescent; D000328:Adult; D017209:Apoptosis; D002356:Cartilage / Q000473:pathology* / Q000637:transplantation; D005151:Facial Injuries / Q000150:complications / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000503:physiopathology / Q000601:surgery*; D009667:Nose Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment