FLRT2 mediates chondrogenesis of nasal septal cartilage and mandibular condyle cartilage.

Nasal septal cartilages (NSCs) and mandibular condyle cartilages (MCCs) are two important cartilages for craniomaxillofacial development. However, the role of FLRT2 in the formation of NSCs and MCCs remains undiscovered. NSCs and MCCs were used for immunocytochemistry staining of collagen II, toluidine blue staining, and alcian blue staining. Quantitative reverse transcription­PCR and western blot were used to detect mRNA and protein expressions of FLRT2, N-cadherin, collagen II, aggrecan, and SOX9. Cell proliferation of MCCs and NSCs was tested by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and cell counting kit­8 assay. Cell migration of MCCs and NSCs was examined by wound healing assay and Transwell. Chondrogenesis of MCCs and NSCs were similar in morphological characteristics, while different in cell proliferation, migration, and extracellular matrix. FLRT2 promotes the proliferation and migration of NSCs. There were up-regulation of N-cadherin and down-regulation of collagen II, aggrecan, and SOX9 in NSC with knock down FLRT2. The current study, as demonstrated by Xie et al., reveals that FLRT2 overexpression in Sprague-Dawley neonatal rats promotes the proliferation and migration of NSCs and MCCs, decreases N-cadherin while increases collagen II, aggrecan, and SOX9 in NSC and MCCs. Altogether, FLRT2 mediates chondrogenesis of NSCs and MCCs.

Endoscopic Endonasal Repair of the Orbital Medial Wall Fracture Utilising Nasal Septal Cartilage as the Reconstructive Material.

BACKGROUND: To repair orbital medial wall fractures, otorhinolaryngologists often use the silicone sheet technique by inserting an inverted U-shaped silicone sheet into the middle meatus after the removal of fractured bones, and packing gauze inside the silicone sheet for several days to fix the shape of the medial wall. However, this method does not sufficiently reduce the orbital content. OBJECTIVE: To describe the surgical procedure to repair medial wall fractures using nasal septal cartilage as the reconstructive material. METHODS: First, endoscopic septoplasty is performed. Although the correction of the septal deviation is performed to secure the operative field, the nasal septal cartilage, except the L-strut is resected simultaneously. After septoplasty, the fractured bones of the lamina papyracea are removed from the herniated orbital contents, and then the orbital contents can be reduced without resistance by pushing laterally. Subsequently, the cartilage is inserted beneath the fracture edges of the orbital medial wall with great care to avoid entrapping the orbital soft tissue and extraocular muscles. RESULTS: The cartilage can be placed appropriately along the medial wall of the orbit. CONCLUSION: This technique enables to repair most cases of orbital medial wall fractures using the endoscopic endonasal approach alone without alloplastic implants.

Sliced vs crushed cartilage for camouflage: long-term graft survival and histological outcomes.

PURPOSE: In this study, we proposed a "sliced-partial thickness cartilage graft" for nasal contour restoration purposes and compared the long-term graft survival and histological changes of sliced, crushed, and intact cartilage grafts. METHODS: Nasal septal and auricular cartilage grafts were harvested from 8 rabbits. Sliced, crushed, or intact cartilage grafts were measured in thickness with a micrometer and re-implanted. 4 months later, specimens were histologically evaluated and thickness were measured. RESULTS: Both nasal septal and auricular crushed cartilage lost significantly more chondrocytes than sliced samples together with fibrosis, multiple fracture lines, and even ossification. Sliced and intact cartilages were histologically similar except sliced cartilage had some minor changes limited to its cut surface. Sliced cartilages retained their thickness, histology, and structural properties in the long term similar to intact cartilages whereas -contrary to expectations- crushed specimens had significantly higher thickness measurements at the end of 4 months. CONCLUSION: Sliced cartilage grafts prepared with an atraumatic cartilage slicer are an ideal camouflaging material with its uniform thickness, and malleability. Crushed cartilages seemingly getting thicker without histological findings could be explained by lower than actual initial measurements due to its structural weakness and getting squeezed when the standard pressure of the micrometer was applied.

Measurement and analysis of morphological parameters of nasal septal cartilage / 中华医学美学美容杂志

Objective:To measure and analyze the morphological parameters of nasal septal cartilage obtained by rhinoplasty in Chinese, so as to provide theoretical guidance for clinical acquisition and application of nasal septal cartilage.Methods:From March 2014 to June 2021, 732 patients were received rhinoplasty in Myoung Beaucare Clinic of Beijing-Cosmetic Surgery. During the operation, 12 mm L-shaped nasal septal cartilage scaffold was obtained from nasal septal cartilage for transplantation. Measurement of the length, width, area, maximum thickness and minimum thickness of nasal septal cartilage was performed for further analysis.Results:For nasal septal cartilage obtained from comprehensive rhinoplasty, its length was 1.2 to 3.5 cm, with an average of 2.16 cm; the width was 1 to 3 cm, with an average of 1.84 cm; the area was 1.43 to 10.5 cm 2, with an average of 4.04 cm 2, with a maximum thickness of 0.5 to 3 mm, with an average of 1.92 mm and a minimum thickness of 0.2 to 0.5 mm, with an average of 0.92 mm. Conclusions:In the comprehensive rhinoplasty of nasal septal cartilage for Chinese, the 12 mm L-shaped nasal septal cartilage scaffold is retained, and the average length, width and area of nasal septal cartilage for transplantation are 2.16 cm, 1.84 cm, 4.04 cm 2, 1.92 mm and 0.92 mm respectively.

Zone-Dependent Architecture and Biochemical Composition of Decellularized Porcine Nasal Cartilage Modulate the Activity of Adipose Tissue-Derived Stem Cells in Cartilage Regeneration.

Previous anatomical studies have shown different functional zones in human nasal septal cartilage (NC). These zones differ in respect to histological architecture and biochemical composition. The aim of this study was to investigate the influence of these zones on the fate of stem cells from a regenerative perspective. Therefore, decellularized porcine septal cartilage was prepared and subjected to histological assessment to demonstrate its equivalence to human cartilage. Decellularized porcine NC (DPNC) exposed distinct surfaces depending on two different histological zones: the outer surface (OS), which is equivalent to the superficial zone, and the inner surface (IS), which is equivalent to the central zone. Human adipose tissue-derived stem cells (ASCs) were isolated from the abdominal fat tissue of five female patients and were seeded on the IS and OS of DPNC, respectively. Cell seeding efficiency (CSE), vitality, proliferation, migration, the production of sulfated glycosaminoglycans (sGAG) and chondrogenic differentiation capacity were evaluated by histological staining (DAPI, Phalloidin, Live-Dead), biochemical assays (alamarBlue®, PicoGreen®, DMMB) and the quantification of gene expression (qPCR). Results show that cell vitality and CSE were not influenced by DPNC zones. ASCs, however, showed a significantly higher proliferation and elevated expression of early chondrogenic differentiation, as well as fibrocartilage markers, on the OS. On the contrary, there was a significantly higher upregulation of hypertrophy marker MMP13 (p < 0.0001) and GAG production (p = 0.0105) on the IS, whereas cell invasion into the three-dimensional DPNC was higher in comparison to the OS. We conclude that the zonal-dependent distinct architecture and composition of NC modulates activities of ASCs seeded on DPNC. These findings might be used for engineering of cartilage substitutes needed in facial reconstructive surgery that yield an equivalent histological and functional structure, such as native NC.

Clinical effect of nasal septal cartilage combined with auricular cartilage on improving nasal tip shape / 中华医学美学美容杂志

Objective:To investigate the surgical method and clinical outcome of using nasal septal cartilage combined with auricular cartilage for management of nasal tip shape.Methods:A clinical study was conducted from April 2014 to June 2019, in which we managed nasal tip shape with nasal septal cartilage and auricular cartilage, and these materials were used as septal extension graft, spreader graft and cap graft. In total, 622 patients (28 males, 594 females; age from 18 to 42 years, mean age 27.47 years) were assessed for eligibility.Results:The follow-up period was from 6 months to 6 years. Nasal shape of all 622 patients was improved significantly after the operation. The nasal tip was natural and round, and there were no complications such as damage of nasal septum mucosa, exposure of prosthesis and infection of surgical site. Only 12 patients were found downward rotation of nasal tip, and 610 patients achieved satisfactory aesthetic results.Conclusions:Using septal cartilage combined with auricular cartilage is a safe, effective and suitable method for management of nasal tip shape.

Endoscopic Tympanoplasty Using Nasal Septal Cartilage Allograft.

The purpose of the study was to analyze the morphological and functional outcomes in a series of 60 patients for whom Type I tympanoplasty was done using alcohol preserved nasal septal cartilage allograft through endoscopic permeatal route. The study was a prospective, interventional (surgical) study of 60 patients between October 2012 and September 2014. Patients were operated using 0°, 4 mm, 18 cm long Hopkin's rod endoscope through permeatal route. 70% ethyl alcohol preserved allogeneic nasal septal cartilage with thickness of around 0.5 mm was used for grafting. At the end of 6 months, final assessment of morphological outcome i.e. intact tympanic membrane and functional outcome i.e. reduction in Air Bone gap, was done. At the end of 6 months, 57 patients (95%) had intact tympanic membrane. Mean ABG in postoperative patients was 11.83 dB. The operative time taken in 42 patients (70%) was 30-45 min. 42 patients (70%) returned to normal activity in 3-5 days. Endoscopic cartilage tympanoplasty using allogenic nasal septal cartilage can be safely and effectively used for Type I tympanoplasty with good anatomical and audiological results with benefits of reduced operating time, morbidity, pain and 'No scar'.

Comprehensive correction of secondary unilateral cleft lip nasal deformity using autologous cartilage and supported by septum cartilage / 中华医学美学美容杂志

Objective To study the surgical method of comprehensive correction of secondary unilateral cleft lip nasal deformity using autologous cartilage and supported by septum cartilage and its outcomes.Methods Our surgery adopted an open approach,fully revealed the deformed alar cartilage and deviated nasal septum cartilage.Part of the nasal septum was removed and made it into various cartilage grafts to repair and reconstruct the columella,nasal tip,nasal alar and nasal dorsal by implanted in the corresponding positions.Results 18 patients with congenital unilateral cleft lip nasal deformity underwent the corrective and reconstructive surgery.The postoperative follow-up was 6-12 months,showing that the malformed nasal appearance came back to normal without obvious scar.The 18 patients did not have associated complications.Conclusions The surgery with a supplementary septal graft achieves good effect,the overall appearance of the malformed nose gets obvious changes,and therefore patients and their families are satisfied with the postoperative nasal shape.

Progress of cartilage in plastic surgery / 医用生物力学

Costal cartilage, auricular cartilage and nasal septal cartilage are widely used in plastic operation. Costal cartilage is used in ear reconstruction and augmentation rhinoplasty, while the auricular cartilage and nasal septal cartilage are applied in the nasal plastic operation. The maintenance of postoperative form is closely related to the biomechanical characteristics of the cartilage. Meanwhile, ultrastructure, especially extracellular matrix, determines the mechanical properties of cartilage. This review mainly focuses on the biomechanical properties and ultrastracture of the cartilages and summarizes the basic data of different cartilages in biomechanical testing, including tissue engineered-auricular cartilage. However, the procedure of biomechanical testing on cartilages currently needs further standardization, and the use of the finite element method should be promoted, so as to offer a better clinical diagnosis and treatment.

Are gender differences in external noses caused by differences in nasal septal growth?

BACKGROUND: The nasal septum plays an important role in nasal growth, but there have been few reports on the relationship between the septum and nasal growth. The authors investigated the relationship between septa and external noses using computed tomography during the growth period. METHODS: One hundred and ninety-eight patients under the age of 21 were enrolled in this study between 2008 and 2012. The authors evaluated a total of 9 measurement items (five for nasal bones and septa, and four for external noses). RESULTS: In the final age group, most measurement items were significantly larger in males than in females. However, there was no remarkable difference between male and female growth processes. Nasal bridge length and nasal height were significantly correlated with the nasal bone or septum in almost all age groups. The relative proportion of the cartilaginous septum decreased significantly with age, and was negatively correlated with the perpendicular plate in all age groups. CONCLUSIONS: Nasal septa and external noses were both larger in males than in females at the beginning of the study period, although not significantly. The differences became significant throughout the study due to differential increases between the sexes during the monitored growth spurts.

Application of autogenous septal cartilage in correction of cleft lip nasal deformity / 中华医学美学美容杂志

Objective To explore the application and efficacy of autogenous septal cartilage in the correction of cleft lip nasal deformity.Methods A total of 31 patients with secondary nasal deformity of cleft lip were involved in this study.After autologous nasal cartilage was released,the dislocation of nasal cartilage was corrected,nasal septum cartilage was used as substitute to raise the alar collapse,to reshape the nasal tip cartilage structure and correct the nasal deformity.Results Postoperative incision was primarily healing.For cartilage donor area there was no serious complications,and incision scar was concealed and unobvious; after 6 months to 2 years follow-up,there was no cartilage absorption deformation,the tip of the nose was flat,crack side nosewing collapses,and nasal columella skew was totally corrected,with stable rhinoplasty effects.Conclusions For secondary nasal deformity of cleft lip,the use of nasal septum cartilage to repair nose deformity can not only solve the cartilage source,but also give septal straightening and at the same time the correction effect of external nasal deformity is good.

Autologous nasal septal cartilage combined with expanded-polytetrafluoroethylene in the secondary nasal deformity correction surgery of postoperative cleft lip / 中华医学美学美容杂志

Objective To correct the nasal deformities of cleft lip by expanded-polytetrafluoroe thylene (e-PTFE) combined with autologous nasal septal cartilage.Methods e-PTFE was placed nearby verge of anterior nasal aperture to raise the fundament of nose.Autologous nasal septal cartilage was harvested and combined with e-PTFE to form a sandwich structure.Nasal tip and collapsed nasaI alar were repaired by this method.Results Fifty cases were treated by this method and 42 cases were followed up for about one year.The results were satisfying.The contour of the nose was similar to normal.Only 3 cases were relapsed after one year.Conclusions e-PTFE combined with autologous nasal septal cartilage is an ideal method to correct nasal deformities of cleft lip.

Rhinoplasty of wide and bulbous nasal tip with a piece of septal cartilage as septal extender / 中华医学美学美容杂志

Objective To evaluate the role of autologous septal cartilage in the rhinoplasty of the wide and bulbous nasal tip. Methods A big piece of autologous nasal septal cartilage was removed and transplanted to the front of nasal septum, acting as a septal extender to fix the nasal alar cartilage,and then the shape of nasal tip was reconstructed by middle crus suture technique, excessive soft tissue under skin of tip and a part of lateral crura cartilage were removed to stand out the shape of the nasal tip. Results After one year follow-up, 118 of 126 cases achieved satisfied effects, but 8 cases dissatisfied because of their undue thick skin. Conclusions This method is reliable in the correction of the wide and bulbous nasal tip.

Autologous septal cartilage grafting in nasal tip augmentation / 中华医学美学美容杂志

Objective To evaluate the role of autologous septal cartilage in nasal tip augmentation.Methods Under local anesthesia,nasal tip was exposed using a"bird-wing"incision.The hypertrophic tissue at the nasal tip was removed.Nasal septal cartilage(2 cm × 1 cm)was harvested.The cartilage was used to augment the nasal tip and nasal alar cartilage.Meanwhile,the cartilage was inserted between the nasal alar cartilages to elevate the nasal tip.Results Among 15 cases,13 were followed after operation.The shape of nasal tip improved at different level.The results were satisfying.Conclusion Compared with other materials,the autologous septal cartilage is an ideal material for nasal tip augmentation without rejection effect.

Nasal development of cleft and non-cleft palate in mice / 实用口腔医学杂志

Objective: To study the relationship between the congenital cleft palate and development of the nasal capsule and nasal septum. Methods: 30 pairs of NMIR fetal mouse at the embryo age of 16～17 days were used.In each pair there was one euploid mouse without cleft palate and one trisomy 18 mouse with cleft palate.Sixty maxillae were precisely orientated in the coronal plane and serially sectioned at 7 ?m thickness. With the aid of computer imaging analysis system the width,height and area of the nasal capsule, nasal septum and cartilage of nasal septum were measured and compared quantitatively between the cleft group and non-cleft group. Results: The values of height and area of the nasal capsule, nasal septum and cartilage of nasal septum in cleft foetuses were smaller than those in non-cleft foetuses (P