title: Determining the most suitable costal cartilage level for rhinoplasty: an experimental study.
abstract: OBJECTIVE
  The aim of this study was to compare the biomechanical properties of septal cartilage (SC) and costal cartilage (CC) grafts harvested from different ribs and to find at which level CC has characteristics closest to SC.
  
  
  METHODS
  Experimental cadaver study.
  
  
  METHODS
  Istanbul Training and Research Hospital.
  
  
  METHODS
  Cartilage grafts were harvested from the 6th, 7th, and 8th ribs and the SC of 10 fresh cadavers. Shaped cartilage grafts were subjected to a bending test. Results were measured, and the force-deflection curve was plotted. Flexural strength (σ(f)) and flexural modulus of elasticity (E(f)) were determined. Fractured surfaces were evaluated by scanning electron microscopy (SEM).
  
  
  RESULTS
  According to F(max), it was determined that ribs 6, 7, and 8 have significantly more durability compared with the SC (Ps = .030, .004, and .001). With regard to deflection, there was no significant difference between the SC and the 6th and 7th ribs and between the 6th and 7th ribs (Ps = 1.000, .088, and .306), while a significant difference was found between the SC and the 8th rib (P = .001). According to σ(f), no differences were seen between the 6th and 7th rib (P = .782), while difference was detected between the 6th and 8th and the 7th and 8th ribs (p = .001). Similar trends were established in E(f) values as in σ(f.) These results were confirmed by SEM images.
  
  
  CONCLUSIONS
  The 7th CC can be used as autograft because it shows similar properties to SC. However, the 6th CC is preferred if more flexibility is desired, and the 8th CC is preferred where more strength is needed.
authors: Department of Otorhinolaryngology, Istanbul Training and Research Hospital, Istanbul, Turkey. z.alkan@yahoo.com
authors: Zeynep
authors: Z
authors: Alkan
authors: Engin
authors: E
authors: Acioglu
authors: Ozgur
authors: O
authors: Yigit
authors: Aylin
authors: A
authors: Bekem
authors: Elad
authors: E
authors: Azizli
authors: Ahmet
authors: A
authors: Unal
authors: Feyzi
authors: F
authors: Sahin
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D002356:Cartilage / Q000502:physiology / Q000637:transplantation; D006801:Humans; D008297:Male; D055171:Nasal Cartilages / Q000502:physiology / Q000637:transplantation; D012225:Rhinoplasty / Q000379:methods*; D012272:Ribs / Q000601:surgery* / Q000637:transplantation; D012680:Sensitivity and Specificity; D013718:Tensile Strength / Q000502:physiology*; D020858:Tissue and Organ Harvesting; D055815:Young Adult