A Systematic Review and Meta-Analysis of Complications Associated With Autogenous Diced Cartilage Wrapped in Fascia Used in Nasal Dorsum Augmentation

Abstract

Background: Nasal dorsum augmentation is a highly challenging rhinoplastic procedure. Problems encountered in this surgery, such as residual humps, irregularities, and asymmetry, account for a significant number of revision rhinoplasties. Objectives: The aim of this meta-analysis was to assess complication rates and graft harvesting site morbidity and revision rates. Methods: We carried out a systematic review of the literature for pertinent materials in PubMed/Medline and Google Scholar up to and including August 2020. In addition, the reference list of included studies was searched manually. The criteria used were those described in the PRISMA Declaration for performing systematic reviews. Results: The initial search yielded 236 results. After 3 stages of screening, 16 papers (18 groups) were included in the systematic review and meta-analysis. Our results indicated that the total rates for the complications studied were as follows: graft resorption, 2.52; insufficient augmentation, 3.93; deviation (graft displacement), 1.77; infection, 2.30; irregularity, 1.36; supra-tip depression, 1.13; overcorrection, 3.06; hematoma at recipient site, 1.36; and visible bulging of the graft, 2.64. The total rates for donor site hypertrophic scar and donor site hematoma were 2.64 and 3.58, respectively. The rate of the revision surgery was 3.03. Conclusions: Current findings suggest the overall complications and revision rates with the use of diced cartilage wrapped in fascia for dorsum augmentation were relatively low and this technique is a reliable treatment choice for patients with primary/secondary dorsum deficiencies. Further studies with larger sample sizes and long-term follow-ups, clearer definitions of complications, and objective measurements are warranted to draw reliable practical conclusions.