A Cartilage Dicing Tool for Rapid Preparation of Rhinoplasty Grafts

Stephanian BA, Karki S, Sharma P, Leo KT, Di Meo MA, Ota M, Patel M, Byrne PJ, Durr NJ
Journal of Medical Devices 14:4, 2020
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Abstract

Over 220,000 rhinoplasties are performed in the U.S. annually, with approximately 90% of all procedures requiring the use of cartilage autografts or allografts to augment nasal structure or contour. Prior to implantation, graft cartilage is shaped into the desired form by facial plastic surgeons through carving, crushing, or dicing, and molding of the tissue. The use of diced cartilage has been shown in literature to be the optimal technique for creating contour grafts, permitting increased graft moldability, and resulting in the fewest postoperative complications. Despite superior clinical outcomes, adoption of diced techniques is challenged by the laborious, time-intensive process of dicing tissue, which requires up to 2 h in the operating room and is currently performed manually with a blade. Manual dicing can result in inconsistently sized pieces, which can increase risk of graft breakage. Existing cartilage processing tools are primarily intended for crushing tissue and are unsuitable for dicing. This work describes the design and validation of an easy-to-use, effective device for rapid, consistent cartilage dicing. Cartilage sizing analysis demonstrated that the device produced approximately five times more diced cartilage within 5 min compared to manual dicing. The rapid dicer (RD) device consistently dices cartilage to a size suitable for grafting while significantly decreasing processing time and cartilage loss compared to current methods. Future development will focus on performing further user testing of the device to design a more ergonomic instrument casing.