Preservation of septal cartilage for early revisions: a histopathological study.

[OBJECTIVE] To determine how storage medium and temperature affect the histological viability of autologous septal cartilage intended for early revision rhinoplasty.

[METHODS] Cartilage specimens stored for 6 and 12 months in four media-dry, gentamicin, cefazolin, and saline-at two distinct temperatures underwent histopathological evaluation after paraffin embedding. The assessed parameters were graft viability, fibrosis, osteoid metaplasia, and peripheral chondroid proliferation.

[RESULTS] Among 480 septal cartilage specimens harvested from 30 patients, overall viability fell from 62 ± 15% at 6 months to 44 ± 14% at 12 months (p < 0.001), while fibrosis, osteoid metaplasia, and peripheral chondroid proliferation all increased significantly (each p < 0.001). Viability declined in every storage condition, but grafts kept at - 80 °C or in saline-based solutions deteriorated fastest, reaching a mean viability of 39% versus 53% for dry storage at - 20 °C at 12 months. Multivariate analysis confirmed - 80 °C storage (OR 2.3, 95% CI 1.4-3.8) and saline media (OR 1.9, 1.1-3.4) as independent predictors of poor viability (< 40%), whereas antibiotic additives were not protective. Histological evidence of osteoid metaplasia (OR 3.6, 1.9-6.8) and peripheral chondroid proliferation (OR 2.1, 1.2-3.7) strongly predicted non-viable grafts. A linear mixed-effects model demonstrated additive negative effects of - 80 °C and saline on both baseline viability and its rate of decline (marginal R² = 0.52). Dry storage at - 20 °C yielded the most favorable long-term viability.

[CONCLUSION] Dry storage of autologous septal cartilage at - 20 °C preserves graft viability well enough to offer a cost-effective alternative for early revision surgeries, warranting confirmation in prospective clinical trials.