TUMEFACTIVE CARTILAGE PROLIFERATION AFTER RHINOPLASTY - A NEWLY REPORTED COMPLICATION

Objective: To describe and document the development of tumoral prolife ration of cartilage in 4 patients after nasal surgery, a complication that, to our knowledge, has not been reported before. Design: Similar postoperative nasal masses were excised from 4 patients who underwent rhinoplasty. Histopathologic evaluation was carried out to identify th e nature of the lesions and to provide a basis for rational management of similar lesions subsequently encountered. Setting: Academic tertia ry referral center. Participants: Four healthy patients (3 women and 1 man) ranging in age from 21 to 49 years. Two of the patients underwen t routine rhinoplasty with resection of cephalic margins of alar carti lages, and 2 underwent augmentation procedures with implantation of au ricular cartilage. Intervention: Discrete firm masses were excised fro m each patient's nose approximately 1 year after the most recent rhino plastic procedure was performed. Histological evaluation was carried o ut on each specimen. Results: All 4 masses were found to consist of tu mefactive proliferation of cartilage. Clonal proliferation and mild nu clear atypia were observed. Conclusions: After rhinoplasty, progressiv e asymmetrical fullness in or adjacent to cartilaginous structures or graft material should suggest the possibility of tumefactive prolifera tion of cartilage and should be evaluated with surgical exploration. A ll areas of thickened cartilage should be excised completely, with imm ediate auricular cartilage reconstruction of resulting anatomical defe cts. Perichondrium should be completely removed from auricular cartila ge implants in the nose, and mechanical injury to the graft should be minimized. We strongly caution against morsellizing dorsal cartilage i mplants for nasal reconstruction.